A pulmonary thrombectomy is a procedure to remove thrombus (a blood clot) from the pulmonary artery. It is primarily performed as an emergency surgery to treat life-threatening pulmonary embolism which occurs when fragments of a clot from a leg or pelvic vein detach and move toward the main artery of the lung. This can happen especially after an operation or prolonged immobility. The procedure is performed with the anticipated outcome of reestablishing blood flow to large arteries, stopping tissue death, and preventing death of the patient.
A pulmonary thrombectomy can be performed two ways. A surgical thrombectomy is the procedure to remove thrombus through surgery via an incision along the clavicle. An arteriogram is used to determine the location and severity of the thrombosis before the procedure. General anesthesia is given and the artery is opened and the clot is removed. Anticoagulants may be given prior to and after the surgery. Percutaneous aspiration thrombectomy is a non-surgical technique that removes the thrombus by aspiration using suction catheters.
Pulmonary embolism can be detected through tests such as chest x-ray, arteriogram, ventilation/perfusion scan and CT arteriogram of the chest. Lung function can be determined through pulse oximetry and arterial blood gasses testing.
It is vital to seek immediate medical attention if signs of pulmonary embolism are present. The signs include:
- Sudden onset of cough
- Sudden onset of shortness of breath
- Rib pain
- Chest pain
- Rapid breathing
- Rapid heart rate
- Clammy or bluish tinted skin
- Nasal flaring
- Pelvic pain
- Pain in one or both legs
- Low blood pressure
- Weak pulse
Complications of a surgical pulmonary thrombectomy can include the risk of artery tears or punctures, heart attack, blockage of more distal arteries, bleeding and swelling. The risk of infection is very small. If patients are on anticoagulation therapy after the surgery, extra care is to be taken to avoid cuts and bruises because of the increased risk of bleeding. The risk of recurrent thrombus formation can be minimized by staying active and avoiding long periods of immobility.
The outcome of a pulmonary thrombectomy procedure is generally good when performed before prolonged loss of blood flow or tissue death.