Embolectomy

Embolectomy
Intervention
ICD-9-CM	39.74, 38.0, 38.1
MeSH	D017128
[]

Embolectomy is the emergency surgical removal of emboli which are blocking blood circulation. It usually involves removal of thrombi (blood clots), and is then referred to as thrombectomy. Embolectomy is an emergency procedure often as the last resort because permanent occlusion of a significant blood flow to an organ leads to necrosis. Other involved therapeutic options are anticoagulation and thrombolysis.

Emboli are abnormal masses of material (which can be solid, liquid or gas) that are carried in the blood stream from one part of the circulation to another causing a blockage (occlusion) of a blood vessel that leads to lack of oxygen supply (ischemia) and finally infarction of tissue downstream of the embolus.

The most common type of emboli are a blood clot generated by thrombosis which has then broken off and is then transported in the blood stream (see embolism).

There are two areas where emboli can form and therefore impact:

Surgical embolectomy for massive pulmonary embolism (PE) has become a rare procedure and is often viewed as a last resort. Thrombolytic therapy has become the treatment of choice.

Surgical or catheter embolectomy is normally performed in patients with pulmonary embolism (formed from venous embolisms). Embolectomy is used for patients with persisting shock despite supportive care and who have an absolute contraindication for thrombolytic therapy. And although other treatments have improved urgent surgical embolectomy or catheter embolectomy may be a life saving procedure in severe pulmonary embolism.

Embolectomies are performed as limb-sparing techniques for arterial embolisms in acute limb ischemia. However, there are also other options, such as catheter-directed thrombolysis and anticoagulation with observation.

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