What is embolectomy?

An embolus is a blood clot, fat, air, or other material that is carried through the blood stream. If the embolus is stuck in a blood vessel and blocks blood flow, it can be a life threatening emergency.

A venous embolus can come from any vein in the body, but often starts as a blood clot (thrombus) in a blood vessel in the legs, called deep vein thrombosis or DVT. An embolus that starts in a vein of the legs or arms is more likely to get stuck in the pulmonary artery (the blood vessel that takes blood from the heart to the lungs to pick up oxygen). This is called a pulmonary embolus.

An arterial embolus usually starts in the heart or large arteries, such as the carotid artery in the neck. An arterial embolus is more likely to travel to the brain and cause a stroke. An arterial embolus may also travel to the arms or legs and get stuck in smaller blood vessels, causing tissue to die from a lack of blood supply.

An embolus is usually treated with medicine to dissolve it. If medicine doesn’t work, you may need surgery to remove the embolus, called an embolectomy.

How is embolectomy done?

Before the procedure:

• Your healthcare provider will ask you to sign a consent form for an embolectomy. The consent form will state the reason you are having the procedure, what happens during the procedure, and what you may expect afterward.
• Tell your healthcare provider if you are allergic to any medicines.
• Tell your healthcare provider if you are taking any medicines, including nonprescription drugs, herbal remedies, or illegal drugs (if any).
• You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow medicine to be given directly into your blood and to give you fluids, if needed.

During the procedure:

• You may be given a sedative through your IV to help you to relax.
• You will be given medicines to prevent pain during your surgery. This is usually done with general anesthesia, which relaxes your muscles and you will be sleep. A breathing tube is usually put in your throat when you have general anesthesia.
• You may have a small tube (catheter) placed into your bladder through the urethra (the opening from the bladder to the outside of the body) to drain and measure urine from the bladder.
• Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
• A cardiac (heart) monitor will be used to keep track of your heart rate and rhythm.
• The surgeon will make a cut in the area over the blood vessel with the clot.
• The blood vessel will be cut and the clot removed.
• The blood vessel will be stitched closed and then the skin will be stitched closed.
• Temporary tubes may be left in place to drain blood and fluid.
• In some cases the surgeon may place a small filter in a blood vessel to prevent blood clots from getting into the heart and lungs.

After the procedure:

• You will be checked often by nursing staff.
• There will be a dressing on the incision. The dressing will be checked and changed by your provider or the nursing staff as needed.
• Your provider may prescribe medicine to:
  • Treat pain
  • Treat or prevent an infection
  • Relax and widen blood vessels and allow blood to flow through them easier
  • Help prevent blood clots
  • Control cholesterol levels
• Your blood oxygen level will be monitored by a sensor that is attached to your finger or earlobe.
• A cardiac (heart) monitor will be used to keep track of your heart rate and rhythm.
• If a drain has been left in the wound, it will be checked and emptied regularly.

What can I do to help?

• You will need to tell your healthcare team if you have new or worsening:
  • Chest pain or pressure, squeezing, or fullness in the center of your chest that lasts more than a few minutes, or goes away and comes back (may feel like indigestion or heartburn)
  • Pain or discomfort in one or both arms or shoulders, or in your back, neck, jaw, or stomach
  • Trouble breathing
  • Breaking out in a cold sweat for no known reason
  • Along with the previous symptoms, feeling very tired, faint, or sick to your stomach
  • Unusual bleeding or bruising or bleeding that does not stop
  • Bluish color of the skin on your leg or toes
  • Dizziness or lightheadedness
  • Feeling like your heart is beating too fast, too slow, or skipping beats
  • Pain at the site of surgery
  • Warmth, redness, or pain in your leg
  • Weakness, numbness, tingling or pain in your face, arm, or leg, especially on one side of your body
• Ask questions about any medicine, treatment, or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many factors. The average amount of time to stay in the hospital after embolectomy is 4 to 6 days.