In cases where patients with MPE are not eligible for thrombolysis or embolectomy
therapy, they may be resuscitated and supported by ECMO until clot dissolution occurs or other interventions, such as an embolectomy
, can be performed.
by transcatheter aspiration.
In patients with massive or submassive PE, in whom fibrinolysis is contraindicated or has failed, surgical embolectomy
may be considered.
When comparing thrombolysis, catheter embolectomy
, and surgical embolectomy
, the mortality was not affected by the treatment modality.
Our search detected one case report on embolectomy
used to treat CFE.
The procedure was performed in a hybrid suite with a multidisciplinary team from interventional cardiology and thoracic surgery enabling fast conversion to extracorporeal circulation and surgical embolectomy
Techniques similar to the one we are proposing include the use of a rigid cystoscope with a 6 Fr embolectomy
balloon catheter, which is used to extract the sheath, (5) or a rigid Storz 26 Fr continuous-flow resectoscope with a rollerball attachment to trap and extract the sheath.
A total of 78 patients were evaluated: 55 with PAH and 23 with CTEPH (7 patients suffered from persistent CTEPH after pulmonary artery embolectomy
and 16 patients declined pulmonary embolectomy
was performed for revascularization of the left lower limb.
The cardiac surgeon considered that a surgical embolectomy
had a major risk because of severe right cardiac disfunction and recent thrombolysis.
In 2013, there were three consecutive trials published in New England Journal of Medicine: Interventional Management of Stroke III, Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy
, and Local Versus Systemic Thrombolysis for Acute Ischemic Stroke (SYNTHESIS Expansion).
Fiona noted how contemporary treatment options for the management of acute stroke have broadened beyond the traditional administration of thrombolytic therapy and now include consideration of endovascular mechanical thrombectomy or embolectomy
for selected cases, either as part of a combination therapy or as a standalone treatment.