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Surgical embolectomy for massive pulmonary embolism (PE) has become a rare procedure and is often viewed as a last resort. Thrombolytic therapy has become the treatment of choice. [1] Surgical or catheter embolectomy is a procedure performed in patients with pulmonary embolism, which is a blockage of an artery in the lung caused by a blood clot.
Surgery is indicated in patients with pulmonary artery emboli that are surgically accessible. Thrombi are usually the cause of recurrent/chronic pulmonary emboli and therefore of chronic thromboembolic pulmonary hypertension (CTEPH). [2] PTE is the only definitive treatment option available for CTEPH. [3]
A study of more than 200,000 women came to the result that admission to inpatient care during pregnancy was associated with an 18-fold increase in the risk of venous thromboembolism (VTE) during the stay, and a 6-fold increase in risk in the four weeks after discharge, compared with pregnant women who did not require hospitalization. [5]
pulmonary embolism (PE) [3] [4] [5] BB00. VTE is a common cardiovascular disorder with significant morbidity and mortality. [3] [4] [5] VTE can present with various symptoms, such as painful leg swelling, chest pain, dyspnea, hemoptysis, syncope, and even death, depending on the location and extent of the thrombus.
Hypercoagulability in pregnancy is the propensity of pregnant women to develop thrombosis (blood clots) such as a deep vein thrombosis with a potential subsequent pulmonary embolism. Pregnancy itself is a factor of hypercoagulability (pregnancy-induced hypercoaguability), as a physiologically adaptive mechanism to prevent post partum bleeding. [7]
A pulmonary thrombectomy is an emergency surgical procedure used to remove blood clots from the pulmonary arteries. Mechanical thrombectomies can be surgical (surgical thrombectomy) or percutaneous (percutaneous thrombectomy). [1] Surgical thrombectomies were once popular but were abandoned because of poor long-term outcomes.
This carries a risk of bleeding and is therefore reserved for those who have a form of thrombosis that may cause major complications. In pulmonary embolism, this applies in situations where heart function is compromised due to lack of blood flow through the lungs ("massive" or "high risk" pulmonary embolism), leading to low blood pressure. [42]
Some patients may present with normal or near-normal pulmonary pressures at rest despite symptomatic disease. These patients are labelled as having chronic thromboembolic disease (CTED). [6] Diagnosis is made after at least three months of effective blood thinning to discern this condition from subacute pulmonary embolism.