Embolectomy and Thrombectomy

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What are embolectomy and thrombectomy?

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Embolectomy and thrombectomy are procedures that remove a blood clot or a foreign body from a blood vessel. Blood clots can grow or break loose and lodge in another blood vessel. Foreign bodies and blood clots can cut off blood supply to organs and tissues, causing a stroke, heart attack, gangrene, loss of limbs, and other serious problems. Your doctor may use one of these procedures as an emergency or scheduled treatment, depending on your condition. 

The terms embolectomy and thrombectomy are sometimes used interchangeably. A thrombectomy is the removal of a blood clot (thrombus). A blood clot or foreign body that has moved and lodged in a blood vessel is called an embolus. An embolectomy is the removal of an embolus. 

Embolectomy and thrombectomy have risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all your treatment choices before having an embolectomy or thrombectomy. 

Types of embolectomy and thrombectomy

There are many types of embolectomy and thrombectomy, depending on the blood vessel needing treatment. The general types include:

  • Catheter-based procedures involve passing a small tube (catheter) through a small incision in the groin to the clot site. Your doctor uses special instruments to break up or remove the clot. The procedure may also involve injecting a clot dissolving medication through the catheter (thrombolysis). Your doctor may also place a mesh stent device in the blood vessel to support it and keep it open.

  • Open surgery involves making a large incision in the area of the blood clot through the blood vessel to remove it. Open surgery is not common, but may be the best choice for emergencies to save an organ and in some other cases.

Other procedures that may be performed

Your doctor may perform other procedures with embolectomy or thrombectomy. These include:

  • Angiography is an imaging procedure that allows your doctor to take X-ray pictures of your arteries (angiogram).

  • Venography takes X-ray pictures of your veins (venogram).

  • Vena cava filter placement involves implanting a special metal filter in your main vein, the vena cava. This filter prevents blood clots from reaching the lungs (pulmonary embolisms).

Why are embolectomy and thrombectomy performed?

Your doctor may recommend embolectomy or thrombectomy to treat many types of blood clots or foreign bodies in a blood vessel. Your doctor may only consider one of these procedures for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion. 

Your doctor may recommend embolectomy or thrombectomy to treat:

  • Blood clots in catheters or grafts, including dialysis catheters, central venous catheters, and bypass grafts

  • Blood clots in peripheral arteries, which are arteries that supply the abdomen, arms and legs with blood

  • Deep vein thrombosis (DVT), which is a clot that develops in a vein in the legs or pelvis. A DVT fragment can break off and travel through the body and cause blockage of a lung artery (pulmonary embolism)

  • Foreign bodies, such as medical devices left in the body after surgery or a procedure

  • Heart attack, which occurs when a clot develops or lodges in an artery that supplies the heart muscle. It causes heart muscle to die from lack of oxygen.

  • Pulmonary embolism (PE), which is a clot that lodges in an artery in the lung

  • Stroke, which occurs when a clot develops or lodges in an artery in the brain (ischemic stroke)

Who performs embolectomy and thrombectomy?

The following specialists commonly perform embolectomy and thrombectomy:

  • Interventional cardiologists specialize in diagnosing and treating heart disease using catheter procedures and radiological imaging.

  • Neuroradiologists specialize in diagnosing and treating diseases and conditions of the brain, spine, head, neck and nerves using radiation and other imaging technologies.

  • Neurosurgeons specialize in the medical and surgical care of people with diseases and conditions of the brain and nervous system.

  • Vascular and interventional radiologists specialize in the treatment of blood vessel conditions and other diseases using catheter-based procedures and imaging techniques.

  • Vascular surgeons specialize in the surgical treatment of blood vessel diseases.

Other specialists who perform embolectomy or thrombectomy include:

  • Cardiac surgeons specialize in the surgical treatment of conditions of the heart and its blood vessels. Cardiac surgeons may also be known as cardiothoracic surgeons.

  • Cardiologists specialize in diagnosing and treating conditions of the heart and its blood vessels.

  • Pulmonologists specialize in the medical care of people with breathing problems and diseases and conditions of the lungs.

  • Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons

How is embolectomy and thrombectomy performed?

Your doctor will perform embolectomy or thrombectomy in a hospital using one of the following approaches:

  • Catheter-based procedures involve passing a small tube (catheter) through a small incision in the groin to the clot site. Your doctor uses special instruments to break up or remove the clot. The procedure may also involve injecting a clot dissolving medication through the catheter (thrombolysis). Your doctor may also place a mesh stent device in the blood vessel to support it and keep it open.

  • Open surgery involves making a large incision in the area of the blood clot through the blood vessel to remove it. Open surgery allows your surgeon to directly view and access the surgical area. Open surgery generally involves a longer recovery and more pain than catheter surgery because it requires cutting and displacement of muscle and other tissues. Open surgery is not common, but may be the best choice for emergencies to save an organ and may be safer or more effective in certain other cases.

Your doctor will advise you on which procedure is best for you and how long you need to stay in the hospital based on your diagnosis, age, medical history, and general health. Learn about the different types of embolectomy and thrombectomy and ask why your doctor will use a particular type for you.
Types of anesthesia 

Your doctor will perform embolectomy or thrombectomy using either general anesthesia or regional anesthesia. 

  • General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the surgery and do not feel any pain.

  • Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb an area of the body. You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.

What to expect the day of your embolectomy or thrombectomy

The day of your surgery, you can generally expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will have.

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.

  • The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.

What are the risks and potential complications of embolectomy and thrombectomy?

As with all surgeries, embolectomy and thrombectomy involves risks and possible complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery. 

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing

  • Bleeding

  • Blood clot, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can travel to your lungs and cause a pulmonary embolism, heart attack, or stroke.

  • Infection and problems related to the spread of infection

Potential complications of embolectomy and thrombectomy

Complications vary depending on the blood vessel that is affected and the type of procedure. Risks may include:

  • Damage to blood vessels

  • Development of another blood clot in the treated blood vessel

  • Heart arrhythmias

  • Heart attack

  • Low blood pressure

  • Movement of the blood clot to another area of the body while trying to remove it

  • Pulmonary embolism

  • Stroke

Reducing your risk of complications

You can reduce the risk of some complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery

  • Informing your doctor if you are nursing or if there is any possibility of pregnancy

  • Notifying your doctor immediately of any concerns, such as dizziness, fainting, shortness of breath, chest pain, bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

How do I prepare for my embolectomy or thrombectomy?

You are an important member of your own healthcare team. The steps you take before your embolectomy or thrombectomy can improve your comfort and outcome. You can prepare for your procedure by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing varies depending on your age, health, and specific procedure. Preoperative testing may include angiography, ultrasound, CT scan, chest X-ray, EKG (electrocardiogram), blood tests, and other tests as needed.

  • If you have high blood pressure, talk to your doctor about how to control it both before and after surgery. Good blood pressure control can help decrease your risk of complications with embolectomy or thrombectomy.

  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before your procedure and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need embolectomy or thrombectomy? Are there any other options for treating my condition?

  • Which type of embolectomy or thrombectomy procedure will I need?

  • How long will the surgery take? When can I go home?

  • What restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery? How do I take my regular medications?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular office hours.

What can I expect after my embolectomy or thrombectomy?

Knowing what to expect can help make your road to recovery after embolectomy or thrombectomy as smooth as possible. 

How long will it take to recover?

You will stay in the recovery room until you are alert, breathing effectively, and your vital signs are stable. You may have a sore throat if a tube was placed in your windpipe during surgery. This is usually temporary, but tell your care team if you are uncomfortable.

You will likely stay in the hospital for several days or more if your embolectomy or thrombectomy was part of an emergency treatment for a heart attack or stroke. Some patients may go home the same day after some procedures. Ask your doctor if you will need to stay in the hospital after your procedure and for how long.

Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, your age, and other factors. Tell your doctor about all your activities and follow all instructions for returning to them. 

Will I feel pain?

Pain control is important to healing and a smooth recovery. There will be discomfort after your procedure. It is common to experience mild tenderness, bruising, and swelling at the incision site. Your doctor will treat your pain or discomfort so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after embolectomy or thrombectomy. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, dizziness, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor's instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Numbness, color change, or a feeling of coolness in the arm or leg that was used to insert the catheter

  • Numbness or weakness on one side of your body or face, or severe headache

  • Pain that is not controlled by your pain medication

  • Sudden confusion, problems with speaking or memory, vision problems, dizziness, trouble walking, or loss of balance

  • Unexpected drainage, pus, redness or swelling of your incision

How might embolectomy or thrombectomy affect my everyday life?

Embolectomy or thrombectomy may cure your condition so you can lead an active, normal life. It will not prevent a blood clot from coming back. You can make changes in everyday life that may help prevent blood clots such as:

  • Drinking plenty of fluids when traveling, exercising, or in dry climates or high altitudes. Dehydration can increase blood clotting.

  • Taking anticoagulant (blood-thinning) medication exactly as directed. You may need to take warfarin (Coumadin) for six months or longer to decrease the risk of having more blood clots.

  • Wearing elastic compression stockings, which prevent blood from pooling and clotting in your veins

  • Walking or flexing your legs every hour on long plane or car trips

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 19
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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