Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Embolectomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources
PubMed1990

[What is the best treatment in massive pulmonary embolism: anticoagulants, thrombolytics or surgical embolectomy?].

The aim of this work was to identify the best treatment available for massive pulmonary thromboembolism which still remains a frequent and sometimes lethal complication for surgical and non-surgical patients. The Authors underline the difficulties of diagnosis and the need for therapy at the earliest possible stage. At present, clinical management involves the use of: anticoagulants, thrombolytic agents and surgical embolectomy. In conclusion, the authors state that pulmonary thromboembolism, even when massive, has been transformed into a medically interesting pathology which can be cured using heparin and thrombolytic agents. However, surgical treatment is mandatory when patients reveal adverse effects to drug therapy, when medical therapy is insuccessful, or when patients are seriously ill with recurrent cardiac arrest.

Anticoagulants↗
PubMed1990

[Embolectomy in fulminant lung embolism and persistent electromechanical uncoupling--a case report and review of the literature].

A 56-year-old patient with deep vein thrombosis shown by phlebography developed a massive pulmonary embolism during perfusion ventilation lung scanning with complete occlusion of the main pulmonary artery branch. 40 minutes after beginning of symptoms the patient suffered from persistent heart failure. Under external heart massage and controlled ventilation a cardio-pulmonary bypass was established after sterniotomy. After manual manipulations to express peripheral emboli pulmonary embolectomy and cava clipping was performed. The patient recovered without neurological damage.

Cardiopulmonary Bypass↗
PubMed1989

[Pulmonary embolectomy for a patient of chronic pulmonary embolism].

Chronic pulmonary embolism is resistant to medicinal treatment. This is a report of the successful operation for chronic pulmonary embolism. A 29-year-old man suffered from dyspnea attack twice half a year in spite of intensive anticoagulant therapy. Cardiac catheterization showed pulmonary hypertension of 72/25 mmHg, mean 42 mmHg. Pulmonary angiogram demonstrated emboli in the right pulmonary artery and pulmonary perfusion scintigram revealed large perfusion defect in the right lung. The patient underwent pulmonary embolectomy after the total cardiopulmonary bypass. After surgery, blood gas showed an increased PaO2 from 65 to 77 mmHg. Pulmonary artery pressure decreased to 39/12 mmHg, mean 23 mmHg. Pulmonary arteriogram showed increased pulmonary vascular beds and pulmonary scintigram showed an increased perfusion in the right lung. The patient has been free from symptom and a half year after surgery.

Adult↗
PubMedDate not supplied

Intraoperative fiberoptic angioscopy to evaluate the completeness of pulmonary embolectomy.

Intraoperative angioscopy was performed in three patients who underwent pulmonary embolectomy for massive pulmonary embolism. Angioscopy followed conventional techniques such as extracting the clot by a gallstone forceps, using a Fogarty catheter in the pulmonary tree or squeezing of the lungs. The rationale for angioscopy was to assess the result of these usual "blind" techniques. In two patients residual thrombus was detected and removed under direct visual control. Our initial experience suggests that intraoperative angioscopy appears to be useful in the detection of residual thrombus material, especially in the asanguinous, arrested heart. The small size of the angioscope allows easily access to the secondary, and up to the tertiary pulmonary branches. Clots can be visualized and extracted under direct visual control.

Adolescent↗
PubMed1989

[Expediency of embolectomy in post-thrombotic occlusion of arteries of the legs].

Restorative operations in patients with acute embologenic arterial obstruction of extremities with terms of the occlusion of the vessels longer than 7 days are thought to be not perspective due to pronounced morphological alterations developing in the vessel wall. Reconstructive-restorative operations are most effective under such conditions but the possibility of them is low because of a severity of the main embologenic disease and the character of the occlusive injury of the vessel. The performance of the timely little-traumatic operation of embolectomy with the help of balloon catheters is a reliable method for prophylactics of postembolic lesions of the vessels.

Acute Disease↗
PubMed1988

[Trendelenburg's operation using an sternostomy approach for pulmonary embolectomy].

Five cases of extremely serious pulmonary embolism treated by embolectomy without extracorporeal circulation have prompted to recall the Trendelenburg's operation through sternotomy. Rapid, simple and requiring little equipment, this technique is perfectly suited to emergency surgery. Its use should save the lives of several patients who would be condemned to death without surgical operation.

Emergencies↗
PubMed1987

Diameter of the brachial artery: the selection of arteriotomy site for embolectomy.

Although it has been demonstrated that embolectomy through an arteriotomy on the brachial artery in the antecubital fossa yields better results than a more proximal arteriotomy, many surgeons continue to expose the artery proximal to the elbow. In this study arteriograms from 11 patients were used to show that the artery is equally wide above and below the elbow. Arteriotomy should therefore be performed at the brachial bifurcation because it provides control of all three arteries. The merits of this exposure are illustrated by two case reports.

Adult↗
PubMed1986

"Closed-open" arterial embolectomy.

Peroperative evaluation of the success of thromboembolectomy is achieved with a technique that employs interrupted horizontal mattress sutures. Angled traction on the sutures functionally closes the transverse arteriotomy while restoration of circulation is assessed. The arteriotomy may be opened for repassing embolectomy catheters by relieving the traction; if circulation is satisfactory the sutures are tied.

Embolism↗
PubMedDate not supplied

Arterial embolectomy in the leg: results in a referral hospital.

A review of 66 patients undergoing femoral embolectomy showed that 38 (58%) obtained a good final outcome (discharge from hospital with viable limb) while 28 (42%) died or required amputation prior to discharge. The major association with poor final outcome was pre-operative life-threatening cardiac disease which occurred in 17 (61%) of those patients who later died or underwent amputation and in six (16%) of those who were discharged with viable limbs (p less than 0.001). Age, sex, source of embolus, duration of ischaemia and pre-existing vascular disease had little effect on final outcome. Surgical dissatisfaction, at the time of operation, with the result of attempted revascularisation was of major prognostic significance in terms of future amputation or death.

Aged↗
PubMed1986

[Use of an embolectomy probe to repair a sectioned lacrimal duct].

We repaired on injured inferior lacrimal duct by using an embolectomy probe. Its inflatable extremity enables it to be retained in the lacrimal sac, supporting only the injured duct and avoiding retrograde intubation. It can be easily withdrawn when its purpose has been accomplished.

Anesthesia, Local↗
PubMedDate not supplied

[Pulmonary embolectomy. Clinical experience].

Between 1969 and 1984, twenty-three patients underwent an emergency pulmonary embolectomy under extracorporeal circulation in the Catholic University of Louvain (UCL), Department of Cardiovascular and Thoracic Surgery. The aim of this paper is to delineate the indications of this procedure. Patients were 23 to 70 years old. Diagnosis of Pulmonary Embolism was made according to clinical signs, ECG and Chest X Ray with Swan-Ganz catheter insertion into the pulmonary artery and the help of pulmonary angiogram if time permitted. The surgical technique is briefly described. Four patients died during the immediate postoperative period and three died later. The sixteen survivors all enjoy a normal life.

Adult↗
PubMedDate not supplied

Practice and theory of "delayed" embolectomy. A 22-year perspective.

A study was made of delayed embolectomy in 45 patients (55 limbs). In 5 patients (11%) the cause of arterial embolization was rheumatic heart disease, and 40 patients (89%) suffered from atherosclerotic cardiovascular disease. The study was divided into 3 phases: I (1960-1964), II (1965-1974) and III (1975-1981). In phases II and III surgery was carried out using the Fogarty catheter technique. In 5 patients the embolus was located in the upper extremity. Seven patients died and 8 major amputations were performed within 30 days of surgery. Use of the Fogarty catheter technique and persistent anticoagulant therapy effected 71.8% limb salvage in phase II and 91.6% limb salvage in phase III. Successful revascularization was achieved in 70.9% of the limbs in which peripheral emboli had occurred on an average of 2.7 days prior to surgical intervention. A theoretical basis for the late development of the acute embolic onset is presented.

Adult↗
PubMedDate not supplied

Massive pulmonary embolism: embolectomy or thrombolysis?

The purpose of this paper is to evaluate the indications for surgical or thrombolytic treatment of massive pulmonary embolism. Analysis of the outcome of the disease depending on the indices of lung vascular damage volume and hemodynamics was performed. One hundred and thirty five patients with thromboembolism of truncus or main branches of the pulmonary artery were examined. Right cardiac catheterization, angiopulmonography and Tc-perfusion lung scanning were carried out. Predictive criteria of the lethal outcome (with 86% probability) were defined in patients without surgical treatment. These criteria included extensive volume of lung vascular damage (Miller angiographic index greater than or equal to 27, scannographic perfusion deficit greater than or equal to 60%) and significant hemodynamic disturbances (refractory systemic arterial hypotension or severe pulmonary arterial hypertension: right ventricular systolic pressure greater than or equal to 60 mmHg, right ventricular end-diastolic pressure greater than or equal to 15 mmHg, mean right ventricular pressure greater than or equal to 25 mmHg, and mean pulmonary arterial pressure greater than or equal to 35 mmHg). With these indices available these are indications for pulmonary artery embolectomy. With lower indices, but close to those estimated in the study, thrombolytic therapy is indicated.

Fibrinolytic Agents↗
PubMed1985

Local intra-arterial streptokinase therapy for acute peripheral arterial occlusions. Should thrombolytic therapy replace embolectomy?

Locally administered low-dose streptokinase was used in 13 patients with acute arterial occlusions. Systemic fibrinolytic effects were noted in each of 11 patients in whom some effective thrombolysis was demonstrated. In the two patients with no angiographically demonstrable thrombolysis, a systemic lytic effect was absent. Bleeding complications were frequent (31%). Three patients required amputations and one patient died. The systemic lytic effects of streptokinase appear to be necessary for complete clot lysis. Locally administered streptokinase appears to have no significant benefit compared to high-dose systemic administration. Occlusions accessible to balloon embolectomy should probably be treated surgically, reserving fibrinolytic therapy for inaccessible lesions. More research is needed to clarify the specific indications, as well as to determine optimal methods of administration and dosage.

Acute Disease↗
PubMedDate not supplied

Arterio-venous fistula in the lower limb in consequence of Fogarty balloon catheter embolectomy. Case report and review of the literature.

Arterio-venous fistula following Fogarty catheter embolectomy is a rare but dangerous complication. The case of a male patient in whom such a fistula was repaired surgically is described. Aggressive approach in the treatment of this severe condition to prevent unnecessary limb loss is advocated. The pertinent literature is reviewed.

Aged↗
PubMed1977

[Massive pulmonary embolism Apropos of 26 embolectomies with definitive survival, 10 of them by Trendelenburg's operation].

The authors report 26 pulmonary embolectomies carried out successfully, 10 of them having been Trendelenberg procedures and 16 having been carried out under extracorporeal circulation. The latter method gives better results, and appears to be the procedure of choice. The haemodynamics before operation were always abnormal, and there were 4 cardiac arrests, 11 cases of severe shock, and 6 cases with less severe hypotension. In the other cases, cyanosis, respiratory distress and signs of acute cor pulmonale were the clinical features of the massive embolus. It was possible to carry out arteriography in 14 cases, and this showed extensive pulmonary vascular obstruction in between 70 and 90%. In 4 cases this procedure was followed by an exacerbation, and extremely urgent treatment became neccessary. This examination is important for diagnosis and for assessment of the prognosis. It seems clear to the authors that surgery has a certain place, alongside medical fibrinolysis of a severe prognosis. It seems clear to the authors that surgery has a certain place, alongside medical fibrinolysis of a severe pulmonary embolus. The essential indications for surgery are moribund patients, those in whom fibrinolysis is contraindicated or unsuccessful, and those with massive obstruction of the pulmonary arterial tree.

Adult↗
PubMed1979

[Surgical treatment through embolectomy of embolism of the superior mesenteric artery (author's transl)].

The Authors present four cases of embolism of the superior mesenteric artery treated surgically, with satisfactory results, through embolectomy with Fogarty's catheter. The Authors affirm the necessity of always following this type of intervention, given its simplicity and the high rate of mortality of non treated embolism. Some anatomical and physio-pathological considerations are remembered and diagnostic and surgical promptness are recommended.

Adult↗
PubMed1983

[Direct pulmonary embolectomy without extracorporeal circulation. 5 cases].

Five patients underwent pulmonary embolectomy without cardiopulmonary bypass. All had recent embolism completely obstructing the right branch of the artery but usually leaving the left branch open or almost totally free. In all patients fibrinolytic drugs were formally contra-indicated. Thoracotomy was performed through the right lateral approach. The embolus was completely removed; there were no post-operative complications and the results on follow-up are excellent.

Adult↗