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PubMedDate not supplied

Low molecular weight dextran in experimental embolectomy.

The canine middle cerebral artery (MCA) was embolized with a pliable cylinder 8 mm long by 1.6 mm in diameter via the internal carotid artery. Both control and experimental embolectomies were performed 6 hours following embolization. The experimental animals were treated with low molecular weight dextran (LMD). In the control animals, the average volume of infarction in the brain was 1.45 cm.3 In the experimental animals the average volume of infarction was 0.13 cm.3

Animals↗
PubMed1976

Renal artery embolectomy.

A patient with rheumatic heart disease developed right renal artery embolism and was treated by renal artery embolectomy. After a brief historical data, etiologic factors, clinicopathologic points, and treatment of the disease have been discussed.

Embolism↗
PubMed1983

Post embolectomy thrombosis treated with intra-arterial streptokinase.

A case is presented which demonstrates the occasional need for selective intra-arterial streptokinase when re-thrombosis has occurred following catheter thromboembolectomy of a peripheral artery. It is recommended that repeat embolectomy be carried out and all mechanical causes for re-thrombosis be excluded before resorting to fibrinolysis. The literature citing other indications for selective arterial use of streptokinase is reviewed.

Adult↗
PubMed1983

Pulmonary embolectomy in the neonate.

Pulmonary embolectomy under cardiopulmonary bypass was performed on a six-day-old infant. The clinical presentation suggested cyanotic congenital heart disease secondary to pulmonary stenosis or atresia with intact ventricular septum. At operation, a large blood clot was found completely occluding a normal pulmonary valve. The use of prostaglandin E1 facilitated cardiac catheterization and emergency surgery.

Cardiac Catheterization↗
PubMed1978

Protective effects of methyl prednisolone and dimethyl sulfoxide in experimental middle cerebral artery embolectomy.

Acute arterial embolism continues to be a major cause of stroke morbidity in children and young adults. Potential therapy modalities include medical management and/or cerebral revascularization. The canine middle cerebral artery (MCA) was embolized by means of a pliable cylinder, 8 mm long by 1.6 mm in diameter, via the internal carotid artery. Control and experimental embolectomies were performed 6 hours following embolization. The experimental animals were treated with either dimethyl sulfoxide (DMSO) or methyl prednisolone. In the control animals, the average area of infarction in the brain was 1.45 cu cm. The animals treated with methyl prednisolone (2 mg/kg) or DMSO (2 gm/kg) showed no infarction of the brain, whereas methyl prednisolone (30 mg/kg) did not prevent infarction.

Animals↗
PubMed1985

Emergency embolectomy for acute occlusion of the middle cerebral artery.

Twenty cases treated with emergency embolectomy for acute occlusion of the middle cerebral artery were reviewed. There were 10 males and 10 females, with an average age of 55 years. The left middle cerebral artery was involved in 17 patients and the right in three. Flow was restored in 16 patients (75%). The embolus originated in the heart in seven, the carotid artery in seven, the aorta in three, an aneurysm in one, and an indeterminate source in two. It was technically most difficult to achieve patency with atheromatous emboli from the aorta. Two patients (10%) had an excellent result with no neurological deficit, five (25%) were left with a minimal deficit but were employable, seven (35%) had a fair result but were still independent and employable, four (20%) did poorly, and two (10%) died. Patients with an associated ipsilateral carotid artery occlusion did poorly. Collateral flow, as judged from preoperative angiograms, was the best predictor of outcome.

Acute Disease↗
PubMed1986

Inadvertent middle cerebral artery embolism by a detachable balloon: management by embolectomy. Case report.

A case of middle cerebral artery embolism by a detachable intra-arterial balloon is presented. The balloon migrated after being detached in an effort to occlude the internal carotid artery proximal to an unclippable giant paraclinoid aneurysm. Volume expansion, induced hypertension, anticoagulation therapy, rapid middle cerebral artery embolectomy, and good collateral circulation are factors that may have contributed to the patient's complete recovery from hemiplegia.

Collateral Circulation↗
PubMed1992

Emergency embolectomy for embolic occlusion of the middle cerebral artery after internal carotid artery balloon test occlusion. Case report.

Balloon test occlusion of the internal carotid artery (ICA) is useful in preoperatively assessing the risk of temporary occlusion or permanent sacrifice of the carotid artery. The incidence of symptomatic complications from this procedure is 1.7%. The case is reported of a 57-year-old woman in whom a balloon test occlusion of the left ICA was attempted. She developed a left ICA dissection/occlusion with subsequent embolization to the left middle cerebral artery, leading to right-sided hemiplegia and expressive aphasia. She was successfully treated by an emergency embolectomy followed by surgical repair of the left ICA, with an excellent outcome. This case represents the most serious complication encountered by the authors in more than 300 balloon test occlusions. Means of avoiding this complication during balloon test occlusion as well as the important factors in managing this problem are emphasized.

Carotid Artery, Internal↗
PubMed1999

Pulmonary embolectomy for acute massive pulmonary embolism under percutaneous cardiopulmonary support.

Portable percutaneous cardiopulmonary support (PCPS) with heparin-coated circuits and a biopump was employed in a patient who had a massive pulmonary embolism with circulatory collapse after stripping of varicosities of the leg. Emergency pulmonary embolectomy was successfully performed. The main pulmonary incision was facilitated by cross-clamping of the main pulmonary arterial root. The bypass circuit was kept closed, and used with the normothermic beating heart without converting to conventional total cardiopulmonary bypass. Blood flow from the lung was removed by pump suction, stored in the reservoir, and intermittently returned to the venous circulation. Heparin was added to the circuits to keep the activated clotting time greater than 300 sec. In massive pulmonary embolism, PCPS is useful for preoperative, intraoperative, and postoperative support.

Acute Disease↗
PubMed1975

[Choice of surgical approach for embolectomy of an artery of the upper extremity].

According to the authors' observations 236 patients with embolism of major arteries of the upper extremities were treated: conservative therapy-in 43, surgery-in 193. Since 1972 in the clinic a unique access in the ulnar fossa with exposure of the brachial artery bifurcation has beem employed for embolectomy from any artery of the upper extemity. A direct access is used only if the necessity of simultaneous correction of the affection leading to embolism (proximally located aneurysms, jugular ribs) might arise.

Arm↗
PubMed1976

Cardiorespiratory failure secondary to peripheral pulmonary emboli. Survival following a combination of prolonged extracorporeal membrane oxygenator support and pulmonary embolectomy.

A 19-year-old woman developed cardiorespiratory failure from multiple, peripheral pulmonary emboli apparently developing over the preceding 3 weeks. She was not considered to be an operative candidate. However, when 3 days of intravenous heparin infusion and 30 hours of membrane oxygenator support failed to improve the pulmonary pathology, pulmonary embolectomy was performed. The membrane oxygenator support had to be continued for 34 hours following the operation before it was successfully discontinued. The patient made a complete recovery.

Adult↗
PubMed1976

Value of intraoperative arteriography in arterial embolectomy surgery.

Clinical assessment of the adequacy of arterial embolectomy and reconstruction is often unsatisfactory and inadequate. Objective information on the state of the distal circulation can be readily obtained at the time of surgery by arteriography. Illustrative cases demonstrating the usefulness of control arteriography obtained during the surgical procedure are presented.

Adult↗
PubMed1989

Use of a removable vena caval filter for prevention of recurrent embolism after emergency pulmonary embolectomy: a flexible approach.

Intraluminal vena caval filters, inserted via the transvenous approach, are used often in the prevention of recurrent pulmonary embolism. Until lately, such filters have been unremovable. In a recent case, however, we treated a patient who experienced acute massive pulmonary embolism after having undergone an emergency right hemicolectomy. He underwent a successful emergency pulmonary embolectomy with the help of cardio-pulmonary bypass; to prevent recurrent embolism, we inserted a removable intracaval filter through the right atriotomy with an introducer set. On the 7th postoperative day, the absence of significant residual thrombi was confirmed by means of phlebography, and the caval filter was removed percutaneously via the femoral approach. Although the value of routine use of the filter in this application has yet to be established, we feel that it warrants further investigation because it relieves the surgeon, during an emergency procedure, of the need to decide quickly whether or not to place a filter. The question becomes one of whether or not to remove the filter, and that decision can await the results of proper postoperative diagnostic studies.

Journal Article↗
PubMed1991

Local thrombolytic therapy as a support for catheter embolectomy in limb arterial occlusions.

Eleven patients with acute arterial occlusion of the lower limb were treated by standard balloon catheter embolectomy. Residual thrombus seen in intraoperative arteriograms was treated with streptokinase: after an initial dose of 10.000 IU, streptokinase was infused intra-arterially in a dose of 5.000-10.000 IU/hour. The average infusion time was 40 hours (range 15-94 hours) and the total amount of streptokinase used was on average 210.000 IU (range 35.000-470.000 IU). All legs were saved. Complete recanalization occurred in eight patients and partial recanalization in three patients. Excluding three inguinal haematomas no other complications occurred.

Aged↗
PubMed1991

[Nonsurgical recanalization of tibial arteries. Balloon dilatation, local fibrinolysis and aspiration embolectomy].

To date, percutaneous angioplasty has only rarely been employed to recanalize arteries in the lower leg. In almost all such patients, the limb has been at risk of being amputated. Since the introduction of special thin-caliber balloon catheters and concomitant drug therapy to prevent vascular spasms and thromboses, results have been markedly improved. In the case of fresh occlusions, local fibrinolysis with percutaneous aspiration embolectomy is employed.

Angioplasty, Balloon↗
PubMed1991

[Long-term prognosis of patients after successful embolectomy in the upper mesenteric artery].

The authors describe case-histories of two patients after successful embolectomy from the mesenteric artery, in one combined with resection of the small intestine with survival of 1 and 13 years resp. without sings of malnutrition. The authors discuss the prognosis of embolectomised patients with regard to the basic disease, relapsing embolization and nutritional disorders.

Aged↗
PubMed1990

[Value of intraoperative lysis therapy as an adjuvant measure after late surgical embolectomy].

The effect of intraoperative local fibrinolysis after delayed catheterembolectomy (CE) of occluded arteries was examined in a model in the dogs hind limb; the superficial femoral artery was occluded by a rapid injection of an autologeous blood clot and ligation. Embolectomy was performed 24 h after occlusion with or without additional local fibrinolysis (urocinase, r-tPA). The success of revascularisation was estimated by measurement of the total periphereal resistance. There happened a total re-occlusion in all vessels within 48 h if only CE was performed; in contrast after additional fibrinolysis a complete revascularisation could be achieved.

Combined Modality Therapy↗