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 109 records · Page 6Linked to original sources
PubMed1986

Trendelenburg pulmonary embolectomy for cardiac arrest secondary to massive pulmonary embolism.

Cardiac arrest secondary to massive pulmonary embolism is rarely reversible by nonsurgical measures. A patient sustained refractory cardiac arrest and was resuscitated by Trendelenburg pulmonary embolectomy without cardiopulmonary bypass. This report describes the diagnosis and treatment of this 37-year-old man and provides a review of the literature on pulmonary embolectomy for patients in whom cardiac arrest has occurred. Awareness of the feasibility of salvaging patients with cardiac arrest secondary to massive pulmonary embolism may lead to wider application of pulmonary embolectomy when conventional resuscitation is unsuccessful.

Adult↗
PubMed1984

Dye-enhanced fluoroscopy-directed catheter embolectomy.

A method is presented that uses a double-lumen balloon catheter to perform embolectomy under contrast-enhanced fluoroscopy control. The technique has the advantage of localization of the thrombi before removal; it permits the individual arterial branches to be entered during embolectomy and allows confirmation of the patency of the arterial tree after completion of the embolectomy.

Catheterization↗
PubMedDate not supplied

Positive and negative effects of anticoagulant treatment during and after arterial embolectomy.

Eighty-four consecutive patients subjected to arterial embolectomy were studied. Cardiac arrythmia was found in 64% of the cases. The incidence of upper limb embolus was 15%, and lower limb 85%. Our total results are in agreement with most reports--the limb salvage rate of survivors was 84%, and the amputation rate was 16%. The primary mortality, 18%, is a rather low figure considering the high mean age (72 years) of the material. The prognosis after embolectomy was dependent on time from onset of symptoms and on the age of the patient. In the group of patients treated with anticoagulants the primary mortality was 7%, and in the untreated group 26%. The results of this investigation of patients treated with arterial embolectomy indicate: Adequate anticoagulant treatment during the per- and postoperative period decreased the primary mortality significantly, possibly as a result of fewer thromboembolic complications. The anticoagulant treatment was associated with a higher frequency of local complications as postoperative hemorrhage and reocclusions, which increased the frequency of reoperations and amputations. These drawbacks of anticoagulant treatment could possibly be counteracted by proper measures during the operation.

Adolescent↗
PubMed1983

Balloon embolectomy catheters in small arteries. IV. Correlation of shear forces with histologic injury.

Experiments were performed in 18 dogs to evaluate the character and time course of arterial injury caused by balloon embolectomy catheters. Injury was correlated with balloon-artery shear forces. Shear forces were regulated intraoperatively. Thirty gram force caused no injury in 14 specimens. Sixty gram force stripped the intimal endothelium in two of four specimens examined at 2 days. Repair consisted of myointimal hypercellularity with return to normal one-cell thickness within 28 days. Ninety and 120 gram force stripped the intimal endothelium in 32 specimens with no medial injury. Repair again consisted of myointimal proliferation, which returned to normal in most vessels at 28 days. All vessels appeared normal at 6 months. This indicates that balloon embolectomy catheters can be a safe operative tool provided excessive shear forces are not imposed. This is quite feasible, for usual embolectomies were found to require about 60 gm shear force. Two hundred gram initial force caused intimal injury and fracturing of the internal elastic lamina, with the latter injury persisting even after 6 months.

Animals↗
PubMed1982

Delayed arterial embolectomy.

Eight instances of delayed or late embolectomy are presented with a review of 241 additional patients from the literature. The time interval from clinical onset to embolectomy ranged from three days to eight weeks in our series and two days to seven weeks in the additional 12 series surveyed. One amputation and seven successful restorations of arterial pulses occurred in our series. One hundred and seventy-two viable extremities, 48 amputations and 30 deaths were reviewed among the additional series. Intraoperative arteriography and a direct operative approach to the distal arterial tree would improve the results for those patients who require a delayed embolectomy.

Adult↗
PubMed1980

[Arterial embolectomy in acute peripheral vascular occlusion (author's transl)].

A series of 68 arterial embolectomies in 59 patients performed during 1970 to 1979 is presented. Limb salvage rate was 67,5%, amputation frequency after embolectomy 5,9%, the mortality rate came up to 17,6%. An analysis of some factors affecting the results after embolectomy, such as causative heart disease, anticoagulation treatment, and time interval between lodgment and removal of embolus, is given. Good results can be expected if surgical treatment is consequently combined with pre- and postoperative anticoagulation and therapy of causative heart disease.

Adult↗
PubMed1993

Intraoperative streptokinase: a useful adjunct to balloon-catheter embolectomy.

Intraoperative thrombolysis was attempted in 31 acutely ischaemic legs after operative arteriography had demonstrated residual distal thrombus or occlusion following balloon-catheter thromboembolectomy. There were 30 patients, 16 men and 14 women, aged 43-82 (median 73) years. The indication for operation was severe ischaemia with sensorimotor loss in 25 limbs, failed percutaneous thrombolysis in three and acute graft occlusion in three. A total of 21 perfemoral, 11 perpopliteal and four graft embolectomies were initially performed. Following arteriography, 100,000 units streptokinase was infused down the isolated distal arterial tree over 30 min and arteriography repeated. Complete lysis was achieved in 11 legs (35 per cent) and partial lysis in 12 (39 per cent). Additional procedures required included six operative angioplasties and six bypass grafts. After operation pedal pulses were restored in 14 limbs (45 per cent), with a viable leg in 23 cases (74 per cent) at the time of patient discharge or death. There were five wound haematomas but no evidence of systemic fibrinolysis. Four amputations were required, none in the group undergoing successful lysis, and there were seven deaths, five from cardiac disease. Arteriography after balloon-catheter embolectomy is essential to detect residual thromboembolus and intraoperative streptokinase appears to be a safe and effective way of removing this.

Adult↗
PubMed1994

[Massive intraoperative pulmonary embolism. Diagnosis and control following embolectomy with transesophageal echocardiography].

Massive intraoperative embolism is a life-threatening condition that may lead to immediate death. Important for the survival of the patient are rapid diagnosis and prompt surgical embolectomy. Case report. Nineteen days after a traffic accident, a 67-year-old patient who had complex ligamentous injuries was operated upon on both knees during general anaesthesia. The operation progressed uneventfully for the first 30 min when the patient's systolic blood pressure became slightly unstable and decreased to 85 mm Hg despite administration of ephedrine and infusion of hetastarch. This was followed 30 min later by an immediate drop to values that were undetectable on an oscilloscope. The pulse oximeter no longer detected a signal at the finger-tip and the end-tidal CO2 decreased to 1 kPa (7.5 mm Hg). To confirm the diagnosis of an acute pulmonary embolism, we performed transoesophageal echocardiography (TEE) and found a large amount of free-floating material in the right atrium, a dilated and hypokinetic right ventricle, and a collapsed left ventricle (Fig. 1 a). Embolectomy was immediately started using the inflow-occlusion technique supported by cardiopulmonary bypass (CPB). All emboli were removed from the right atrium and pulmonary artery (Fig. 1 b). During closure of the sternotomy, heart function was monitored by TEE and we again noted large emboli in the right atrium (Fig. 1 c). To remove these, we reinstated CPB and then placed an inferior vena cava filter. The final TEE control showed free heart chambers with good contractility (Fig. 1 d).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Embolectomy of a Bird's Nest Vena Caval Filter.

In this case report we describe a successful embolectomy of a partially migrated Bird's Nest Caval Filter with attached embolic material. We used transesophageal echocardiography to guide the surgical approach. The patient recovered uneventfully from both the embolectomy and the subsequent pelvic operation.

Echocardiography, Transesophageal↗
PubMed2004

Neodymium:yttrium-aluminum-garnet laser arteriotomy with embolectomy for central retinal artery occlusion.

PURPOSE: To describe a patient with central retinal artery occlusion successfully treated with neodymium:yttrium-aluminum-garnet laser arteriotomy and embolectomy. DESIGN: Interventional case report. METHODS: A 77-year-old woman noted sudden loss of vision after vigorous coughing. A central retinal artery occlusion was diagnosed. Four hours after symptoms appeared, arteriotomy and embolectomy with neodymium:yttrium-aluminum-garnet laser was performed. RESULTS: Displacement of embolus outside the artery with return of retinal perfusion and recovery of vision. Laser treatment also resulted in vitreous hemorrhage and false aneurysm formation of the central retinal artery. CONCLUSIONS: Neodymium:yttrium-aluminum-garnet laser arteriotomy in a patient with central retinal artery occlusion resulted in extrusion of the embolus, reopening of the central retinal artery, and return of vision. This technique warrants further study as a primary treatment for this blinding disorder.

Aged↗
PubMed2001

Successful resuscitation of acute massive pulmonary embolism with extracorporeal membrane oxygenation and open embolectomy.

Acute massive pulmonary embolism is usually fatal if not treated aggressively, but the management is not standardized. Open pulmonary embolectomy retains a role in the treatment of this disastrous disease. Extracorporeal membrane oxygenation has been used for cardiopulmonary support in some patients with life-threatening pulmonary embolism. This article details our experience of a 58-year-old woman suffering from acute cardiopulmonary collapse caused by massive pulmonary embolism. Under extracorporeal membrane oxygenation support, the patient received pulmonary angiography and underwent open embolectomy for a definitive treatment.

Acute Disease↗
PubMed2004

Successful resuscitation of a patient with acute massive pulmonary embolism using emergent embolectomy.

Acute massive pulmonary embolism is associated with a high mortality rate. Prompt diagnosis and treatment are mandatory for a successful outcome. Although thrombolysis is effective, it is associated with a high rate of bleeding complications. This report describes the use of emergent pulmonary embolectomy as an effective and aggressive therapeutic approach to a massive saddle pulmonary embolism in a 66-year-old woman. With the application of specific surgical techniques and good interdisciplinary cooperation, pulmonary embolectomy may serve as more than a last resort for the management of this clinically unstable and dangerous condition.

Acute Disease↗
PubMed1998

Left anterior thoracotomy for pulmonary embolectomy with 29-year follow-up.

Pulmonary embolectomy is usually performed in cardiopulmonary bypass. In acute situations too much time can be lost in setting up and connecting the pump oxygenator; this delay can cause cerebral damage in a patient with circulatory arrest. In such a situation left anterior thoracotomy can provide an ideal approach. An emergency thoracotomy can be performed in a few seconds. The lung automatically retracts. The phrenic nerve, pulmonary artery, and pericardium are clearly seen, and they outline the area for embolectomy. A case in which such an approach was successfully used is described.

Aged↗
PubMed1997

Surgical emergency embolectomy for the treatment of fulminant pulmonary embolism in a preterm infant.

A massive pulmonary embolism, demonstrated by echocardiography developed in a 3-week-old preterm infant. An etiologic explanation could not be obtained from either history or clinical and laboratory findings. Pulmonary embolectomy was performed as an emergency procedure because of severe hemodynamic impairment despite intensive medical therapy. In children who have massive pulmonary embolism who remain in a compromised hemodynamic state despite intensive medical therapy, pulmonary embolectomy may be considered the alternative emergency treatment.

Embolectomy↗
PubMed1996

Amputation risk and survival after embolectomy for acute arterial ischaemia. Time trends in a defined Swedish population.

OBJECTIVES: To assess the outcome of embolectomy over an 19 year period. METHODS: Time trends in the outcome of acute arterial thrombo-embolectomy of the extremities were analysed in a population-based cohort of 1190 patients operated on between 1965-83. RESULTS: A total of 262 (22%) initial amputations were performed. The limb salvage rates at 5 years postoperatively were lower between 1975-79 (61%) than between 1965-69 (81%). A proportional hazards model revealed a relative hazard (RH) of amputation of 2.2 (95% confidence interval (CI) 1.3-3.3) for 1975-79 compared with 1965-69. Operation at any district hospital entailed a 70% higher risk of amputation (RH 1.7; 95% CI 1.3-2.5) compared with the University hospital. The relative survival rate at 5 years postoperatively decreased towards the end of the study period (33% between 1975-79 compared with 43% between 1965-69). Younger age-groups had a considerably lower risk of death in the University hospital compared with the county and district hospitals. CONCLUSIONS: Contrary to the results in other hospital based reports no improvement in amputation or survival rates since 1965 could be demonstrated in this large series with no patient selection.

Acute Disease↗
PubMed2001

Transvenous catheter embolectomy.

Transvenous pulmonary embolectomy was first described in 1969 by Greenfield and associates who designed a special catheter for the aspiration of thrombi in the pulmonary circulatory system. This technique was applied in 64 patients with massive pulmonary embolism (PE) with a 70 to 72% survival rate. However, it is difficult to implement and has not gained widespread acceptance. More recently, several other catheter devices have been used in patients with PE. The total number of patients reported does not exceed 100. Relative angiographic improvement varies between 10 and 49%, but hemodynamic improvement is not observed or not measured in most patients and mortality varies between 9 and 30%. Fibrinolysis was associated with mechanical thrombectomy in 54% of the patients, making the results difficult to interpret. Transvenous pulmonary embolectomy remains an experimental procedure and should been attempted only in the very few patients with PE, uncontrolled cardiogenic shock, and absolute contraindication to fibrinolytic treatment. Animal models are required to compare the different devices available.

Catheterization, Central Venous↗
PubMed1999

The urgent pulmonary embolectomy: mechanical resuscitation in the operating theatre determines the outcome.

BACKGROUND: The urgent pulmonary embolectomy as a surgical treatment of acute massive pulmonary embolism (PE) is still the subject of controversial discussion regarding indication, operative technique, and prognosis. METHODS: From 10/89 to 9/97 40 patients underwent urgent exploration of the pulmonary artery with the aid of extracorporeal circulation (ECC). RESULTS: The overall operative mortality was 35%. Univariate and multivariate logistic regression analysis showed preoperative hemodynamics and cardiopulmonary resuscitation (CPR) as the most important predictive factors for outcome: mortality rate was significantly higher after CPR (=63%) than without CPR (=10%) (p = 0.001). Other factors such as immobility, overweight, and concomitant cardiopulmonary disease also had an influence on the postoperative outcome. CONCLUSIONS: Pulmonary embolectomy (on the beating heart with ECC under total bypass) under stable hemodynamics, without CPR however, still constitutes an important form of treatment of acute massive PE with excellent long-term results.

Acute Disease↗