Pulmonary thrombectomy

Pulmonary thrombectomy

In thoracic surgery, a pulmonary thrombectomy, is an emergency procedure that removes clotted blood (thrombus) from the pulmonary arteries.

Mechanical thrombectomies can be surgical (surgical thrombectomy) or percutaneous (percutaneous thrombectomy). [Casazza F, Roncon L, Greco F. Pulmonary embolism: treatment of the acute episode. Ital Heart J. 2005 Oct;6(10):818-23. PMID 16270473.]

Surgical thrombectomies were once popular but were abandoned because of poor long-term outcomes. Recently, in selected patients, they have gone through a resurgence with the revision of the surgical technique. [Augustinos P, Ouriel K. Invasive approaches to treatment of venous thromboembolism. Circulation. 2004 Aug 31;110(9 Suppl 1):I27-34. PMID 15339878. [http://circ.ahajournals.org/cgi/content/full/110/9_suppl_1/I-27 Free Full Text] .]

Relation to PTE

Pulmonary thrombectomies and pulmonary thromboendarterectomies (PTEs) are both operations that remove thrombus. Aside from this similarity they differ in many ways.
*PTEs are done non-emergently whilst pulmonary thrombectomies are typically done as an emergency procedure.
*PTEs typically are done using hypothermia and full cardiac arrest.
*PTEs are done for chronic pulmonary embolism, thrombectomies for severe acute pulmonary embolism.
*PTEs are generally considered a very effective treatment, surgical thrombectomies are an area of some controversy and their effectiveness a matter of some debate in the medical community.

ee also

*Pulmonary embolism
*Heart-lung machine

References


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