Thrombectomy: Difference between revisions

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Revision as of 14:17, 5 November 2012

Template:Interventions infobox

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

A thrombectomy is the excision of an abnormal or dangerous thrombus (blood clot). It is performed intraluminally (meaning directly in the cavity of a vessel) using a balloon catheter. The thrombus is then either pressed against the walls in order to restore at least part of the natural lumen; or the balloon is 'opened' after the thrombus and then carefully moved retrogradely so that the clot can be drawn out of the vessel.

Thrombectomies usually occur as a result of thrombosis or a blood clot in a vein or artery. Thrombectomies can be used to clear a blockage in a fistula (AV fistulas used for dialysis kidney treatment).

Indications

An unsuccessful treatment with fibrinolysis.
The occurrence of a mobile thrombosis
Phlegmasia coerulea dolens

Types

Catheter Thrombectomy: which is of further divided into

Balloon Thrombectomy
Aspiration Thrombectomy.

Surgical Thrombectomy

Video explaining Thrombectomy

{{#ev:youtube|RowX9f5YGzU}}

Related Chapters

References

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 *The occurrence of a mobile thrombosis
 *Phlegmasia coerulea dolens
-===ACCF/AHA/SCAI 2011 Guidelines for Percutaneous Coronary Intervention: Thrombectomy<ref name="pmid22070837">{{cite journal |author=Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH |title=2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions |journal=[[Journal of the American College of Cardiology]] |volume=58 |issue=24 |pages=2550–83 |year=2011 |month=December|pmid=22070837|doi=10.1016/j.jacc.2011.08.006|url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(11)02875-0|accessdate=2011-12-08|url=http://content.onlinejacc.org/cgi/reprint/58/24/2550.pdf|PDF}}</ref> (DO NOT EDIT)===
-{|class="wikitable"
-|-
-| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
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-|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[Thrombectomy|Aspiration thrombectomy]] is reasonable for patients undergoing primary PCI.<ref name="pmid19161878">{{cite journal |author=Sardella G, Mancone M, Bucciarelli-Ducci C, Agati L, Scardala R, Carbone I, Francone M, Di Roma A, Benedetti G, Conti G, Fedele F |title=Thrombus aspiration during primary percutaneous coronary intervention improves myocardial reperfusion and reduces infarct size: the EXPIRA (thrombectomy with export catheter in infarct-related artery during primary percutaneous coronary intervention) prospective, randomized trial |journal=[[Journal of the American College of Cardiology]] |volume=53 |issue=4 |pages=309–15 |year=2009 |month=January|pmid=19161878 |doi=10.1016/j.jacc.2008.10.017|url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(08)03542-0|accessdate=2011-12-10}}</ref><ref name="pmid18539223">{{cite journal |author=Vlaar PJ, Svilaas T, van der Horst IC, Diercks GF, Fokkema ML, de Smet BJ, van den Heuvel AF, Anthonio RL, Jessurun GA, Tan ES, Suurmeijer AJ, Zijlstra F |title=Cardiac death and reinfarction after 1 year in the Thrombus Aspiration during Percutaneous coronary intervention in Acute myocardial infarction Study (TAPAS): a 1-year follow-up study |journal=[[Lancet]] |volume=371 |issue=9628 |pages=1915–20 |year=2008|month=June |pmid=18539223 |doi=10.1016/S0140-6736(08)60833-8|url=http://linkinghub.elsevier.com/retrieve/pii/S0140-6736(08)60833-8|accessdate=2011-12-10}}</ref><ref name="pmid18812323">{{cite journal |author=Bavry AA, Kumbhani DJ, Bhatt DL |title=Role of adjunctive thrombectomy and embolic protection devices in acute myocardial infarction: a comprehensive meta-analysis of randomized trials |journal=[[European Heart Journal]]|volume=29 |issue=24 |pages=2989–3001 |year=2008 |month=December |pmid=18812323|doi=10.1093/eurheartj/ehn421 |url=http://eurheartj.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=18812323 |accessdate=2011-12-10}}</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
-|}
 ==Types==
 '''Catheter Thrombectomy''': which is of further divided into