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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.
Fogarty arterial embolectomy catheter is a device developed in 1961 by Dr. Thomas J. Fogarty to remove fresh emboli in the arterial system. [1] It consists of a hollow tube with an inflatable balloon attached to its tip. The catheter is inserted into the blood vessel through a clot.
Catheter-directed thrombolysis (CDT) is a new technique found to be relatively safe and effective for massive PEs. This involves accessing the venous system by placing a catheter into a vein in the groin and guiding it through the veins by using fluoroscopic imaging until it is located next to the PE in the lung circulation.
Embolization refers to the passage and lodging of an embolus within the bloodstream. It may be of natural origin (pathological), in which sense it is also called embolism, for example a pulmonary embolism; or it may be artificially induced (therapeutic), as a hemostatic treatment for bleeding or as a treatment for some types of cancer by deliberately blocking blood vessels to starve the tumor ...
In 1969, Fogarty patented his device, and Edwards Life Sciences from Irvine, California, was assigned the patent to begin manufacturing the Fogarty embolectomy catheter. Because of the decreased risk associated with the device, Fogarty's balloon catheter became the industry standard and remains the most widely used catheter for blood-clot removal.
Transcatheter arterial chemoembolization (TACE) is a minimally invasive procedure performed in interventional radiology to restrict a tumor's blood supply. Small embolic particles coated with chemotherapeutic drugs are injected selectively through a catheter into an artery directly supplying the tumor.
Preoperative PVE is a very well tolerated procedure with extremely low mortality rates (0.1 percent) and technical failure rates (0.4 percent). [3] Complication rates from the procedure are low as well (2–3 percent) and include portal vein thrombosis, liver infarction, necrosis, infection, pneumothorax, and other risks as listed above. [3]
In contrast to surgical embolectomy for acute PE, treatment of CTEPH necessitates a true bilateral endarterectomy (removal of blockage from the blood vessels) through the medial layer of the pulmonary arteries, which is performed under deep hypothermia (lowering of body temperature) and circulatory arrest (temporary stoppage of blood flow), [16 ...