Embolectomy

Embolectomy is a necessary operation to save a life in case of blockage of the pulmonary artery, as well as to avoid gangrenous process in case of blockage of an artery in the limb ^[1] .

Embolectomy has great potential for saving lives in the event of acute pulmonary embolism despite the high mortality rate among such patients ^[2] .

Typically, an embolectomy operation is performed using an aspiration catheter by suctioning the embolus with reduced pressure into the can. Through an incision about 10 mm long in the femoral or other artery, a probe with a balloon attached to the syringe in the hands of the surgeon is launched into the bloodstream. After creating a reduced pressure with a syringe, the can is filled with an embolus and the probe is removed. The procedure is repeated on the other side of the thrombus ^{[1] [3]} . This is the most sparing and quickest way to remove the embolus, for example, it is used to remove the embolus located below the inguinal ligament in case of leg infarction ^[3] .

Another option is to use an inflatable balloon at the end of the catheter. A catheter is inserted behind the embolus, the balloon is inflated, and the catheter with the balloon is removed from the artery along with the embolus. The disadvantages of the method include the risk of damage to the vascular wall up to rupture of the artery and the risk of creating a new embolus from cholesterol plaques ^[4] .

The third option is an open embolectomy - an incision at the location of the embolus and extraction with tweezers. It is used, in particular, in the treatment of acute massive pulmonary artery thromboembolism ^[5] .

Comparison of pulmonary embolectomy from 1961 to 2006 showed a decrease in patient mortality after surgery in newer operations: in the case of pulmonary embolectomy, the mortality of patients after 1985 was about 20%, before 1985 - 32% ^[2] .

In acute pulmonary embolism (1961–2006), in cases with cardiac arrest before surgery, mortality after embolectomy is 59%, while in patients without previous cardiac arrest, 29% ^[2] .

• Embolus
• Thrombus
• Embolism
• Embolization

• Aho, Pekka. Kirurgiska åtgärder vid akut ischemi i nedre extremitet: [ fin. ] / Pekka Aho, Pirkka Vikatmaa // Finska Läkaresällskapets Handlingar. - 2003. - No. one.
• Oğuzkurt, L. Percutaneous aspiration thrombectomy in the treatment of lower extremity thromboembolic occlusions: [ eng. ] / L. Oğuzkurt, U. Ozkan, B. Gümüş ... [et al. ] // Diagn Interv Radiol: J. - 2010. - Vol. 16, no. 1 (March). - P. 79–83. - DOI : 10.4261 / 1305-3825.DIR.2654-09.1 . - PMID 20044798 .
• Stein, PD Outcome of pulmonary embolectomy: [ eng. ] / PD Stein, M. Alnas, A. Beemath ... [ et al. ] // The American Journal of Cardiology. - 2007. - Vol. 99, no. 3 (February 1). - P. 421-423. - DOI : 10.1016 / j.amjcard.2006.08.050 . - PMID 17261411 .
• Medvedev, A. P. Open embolectomy in the treatment of massive pulmonary thromboembolism : [ arch. July 12, 2019 ] / A.P. Medvedev, S.V. Nemirova, V.V. Pichugin ... [ and others. ] // Medical almanac. - 2013. - No. 4. - P. 57−60.

• Embolectomy (Russian) . City Clinical Hospital named after D. D. Pletnev of the Moscow Department of Health. Date of treatment July 12, 2019.
• Greenberg, M.V. Pulmonary thromboembolism - symptoms and treatment (Russian) . Diseases Treatment of pulmonary embolism: MedRating LLC (May 14, 2018). Date of treatment July 12, 2019.