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Embolectomy

AMBULATORY CARE:

What you need to know about an embolectomy:

An embolectomy is surgery to remove an embolus from an artery or vein. An embolus is part of a blood clot that broke free. It can travel through your bloodstream and become stuck in another area. This is called an embolism. An embolism can block blood flow to the area. An embolus in your vein can reach your lungs. This is called a pulmonary embolism, or PE. An embolus in your artery can reach your brain. This can cause a stroke. An embolus in a femoral artery in your leg can cause tissue death in the leg. An embolus in an artery in your abdomen can cause pain and vomiting. An embolectomy is used when medicines or procedures cannot be used, or are not successful.

Thrombus and Embolus

How to prepare for an embolectomy:

An embolectomy may need to be done as immediate emergency surgery. If you are able to plan for surgery, your surgeon will tell you how to prepare.

  • Contrast liquid may be used during surgery to help your surgeon see the blood vessel and embolus better. Tell your surgeon if you have ever had an allergic reaction to contrast liquid. Tell your surgeon if you have had an allergic reaction to anesthesia. He or she may use local anesthesia instead.
  • Tell your surgeon about all medicines you are currently taking. You may need to stop taking certain medicines before surgery. You will be told which medicines to take or not to take on the day of surgery.

What will happen during an embolectomy:

  • You may be given local anesthesia to numb the area so you do not feel pain. You may instead be given general anesthesia to keep you asleep and free from pain.
  • The following are ways the embolus may be removed:
    • A catheter embolectomy is a minimally invasive surgery. A catheter (thin tube) is guided into the vein or artery that has the embolus. Suction is used to remove the embolus through the catheter.
    • A balloon embolectomy is also minimally invasive. A catheter with a balloon on the end is guided into the vein, past the clot. The balloon is inflated (filled) and pulled back out of the vein. The embolus comes back through the vein with the catheter. The balloon helps move the embolus and keep it from continuing into the vein.
    • An open embolectomy is usually only done for a large embolus, most often to treat a PE. Your surgeon will make an incision in the skin over the embolus. He or she will open the vein or artery and remove the embolus.
  • A filter may be placed to prevent another embolus from being able to travel through your body. Your surgeon will check that all of the embolus was removed. He or she may place a filter in the blood vessel. The filter helps prevent pieces of the embolus from continuing to travel. When blood flows freely, your surgeon will close the vein or artery. The incision area will be covered with a pressure bandage.

What to expect after an embolectomy:

  • You may have swelling or pain in the procedure area. You may be given medicines to reduce pain or swelling. You may need to stay in the hospital for up to 1 week, depending on where you had the embolectomy. You may need to lie still for several hours right after your procedure.
  • Healthcare providers will help you walk around the same day of your procedure, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your healthcare provider says you can. Ask before you get up the first time. You may need help to stand up safely.
  • Healthcare providers will change the bandage over the embolectomy site as needed.

Risks of an embolectomy:

You may bleed more than expected or develop an infection. The blood vessel or tissues near the area may be damaged. Your surgeon may not be able to remove the embolus. Pieces of the embolus may break free and continue through the blood vessel.

Call your local emergency number (911 in the US) if:

  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest
    • You may also have any of the following:
      • Discomfort or pain in your back, neck, jaw, stomach, or arm
      • Shortness of breath
      • Nausea or vomiting
      • Lightheadedness or a sudden cold sweat
  • You have any of the following signs of a stroke:
    • Numbness or drooping on one side of your face
    • Weakness in an arm or leg
    • Confusion or difficulty speaking
    • Dizziness, a severe headache, or vision loss
  • You feel lightheaded, short of breath, and have chest pain.
  • You cough up blood.

Contact your doctor or surgeon if:

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • The surgery area does not stop bleeding even after you apply firm pressure for 10 minutes.
  • The leg or arm used for your procedure is numb, painful, or changes color.
  • The bruise at your catheter site gets bigger or becomes swollen.
  • You have purple spots or blisters on your skin.
  • You have a fever.
  • You have a new skin rash and itching.
  • You feel weak, lightheaded, or faint.
  • You have new swelling around your eyes.
  • You see blood in your urine.
  • You have pain at the surgery site that does not get better with pain medicine.
  • You have questions or concerns about your condition or care.

Medicines:

  • Antiplatelets , such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.
  • Blood thinners help prevent blood clots. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
    • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
    • Tell your dentist and other healthcare providers that you take a blood thinner. Wear a bracelet or necklace that says you take this medicine.
    • Do not start or stop any other medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
    • Take your blood thinner exactly as prescribed by your healthcare provider. Do not skip does or take less than prescribed. Tell your provider right away if you forget to take your blood thinner, or if you take too much.
    • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin:
      • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
      • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow your surgeon's directions for daily activities.

Your surgeon will give you instructions based on the type of embolectomy you had. The following are general safely guidelines to follow:

  • Your healthcare provider will tell you when it is safe to drive and do normal daily activities. Go slowly at first. Then increase your activity. An active lifestyle can help prevent blood clots.
  • Do not lift anything heavier than 10 pounds for 2 days after your procedure. For example, a gallon of milk weighs 8 pounds.
  • Do not strain when you have a bowel movement. This may cause bleeding from the area where you had the embolectomy. Ask your healthcare provider if you need medicine to help make your bowel movements easier.

Wear pressure stockings as directed.

Pressure stockings help keep blood from pooling in your leg veins. Your healthcare provider can prescribe stockings that are right for you. Do not buy over-the-counter pressure stockings unless your healthcare provider says it is okay. They may not fit correctly or may have elastic that cuts off your circulation. Ask your healthcare provider when to start wearing pressure stockings and how long to wear them each day.

Pressure Stockings

Keep your leg elevated as directed.

Keep your leg above the level of your heart when you are sitting. Prop your leg on pillows to keep it elevated comfortably. Ask how long to keep your leg elevated each day. You will need to balance elevation with movement to prevent blood clots.

Watch for bleeding and bruising.

It is normal to have a bruise and soreness where you had an embolectomy. Contact your healthcare provider if your bruise gets larger. If the area bleeds, use your hand to put pressure on the bandage. If you do not have a bandage, use a clean cloth to put pressure over and just above the area. Seek care immediately if the bleeding does not stop within 10 minutes.

Stay active to prevent another blood clot.

Your healthcare provider will tell you when it is safe to drive and start doing your other normal daily activities. Go slowly at first. Then increase your activity. An active lifestyle can help prevent blood clots. Try to get at least 30 minutes of activity on most days of the week. If you sit most of the day for work, stand or walk around every half hour. After a future injury or illness, try to become active again as soon as possible. Activity can also help you manage your weight. Overweight or obesity can put pressure on your leg veins and cause blood to pool. This increases your risk for another blood clot.

Walking for Exercise

Care for the surgery area as directed.

  • Keep the area clean and dry. Ask your healthcare provider when you can bathe. You will need to keep the bandage in place and dry for a day or two after your procedure. Cover the bandage with a plastic bag and tape the opening around your skin to keep water out.
  • When you are allowed to bathe without a bandage, carefully wash around the area with soap and water. Let soap and water run gently over the area.
  • Check the area every day for signs of infection, such as redness, swelling, or pus. Dry the area and put on new, clean bandages as directed. Change your bandage if it gets wet or dirty.

Drink more liquids.

Liquid can help prevent blood clots. Ask your healthcare provider how much liquid to drink each day and which liquids are best for you.

Do not smoke.

Nicotine and other chemicals in cigarettes and cigars can cause blood vessel and lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

Limit alcohol.

Limit alcohol to 1 drink a day if you are a woman. Limit alcohol to 2 drinks a day if you are a man. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

Follow up with your healthcare provider as directed.

You may need to be checked for blood clots for up to 3 years after treatment. Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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