Thrombectomy – types of surgery, indications

Thrombectomy is a surgical intervention aimed at removing a thrombus from the place of its attachment to the vascular wall, extracting a blood clot. Two methods have become widespread: traditional and endovascular, in which the thrombus is removed without violating the integrity of the vein or artery. According to the traditional method, the vascular surgeon makes an incision in the vessel wall and removes the clot using a catheter with a stent. As a result of the operation, the blood flow is completely restored, the patient’s condition is greatly facilitated.

Endovascular thrombectomy

Thrombectomy - types of surgery, indications

In modern vascular surgery, thromboembolectomy, or endovascular thrombectomy, is gaining popularity. During the operation, the thrombus is removed mechanically, while the vessel is preserved. In preparation for surgery, angiography is used to determine the location of the blood clot.

 During surgical intervention, the vessel is incised in the projection of the edge of the clot that clogged the vessel. An empty catheter balloon is inserted into the incision under X-ray control. When it comes into contact with a thrombus, the balloon is filled with saline and removed along with the thrombus. The introduction and removal of the catheter is performed several times until the vessel is completely cleansed.

Hemostasis during manipulation is maintained using electrosurgical equipment.

Types of non-radical thrombectomy:

  • Thrombolysis – a highly antigenic procedure, which implies a long-term administration of drugs softening a blood clot into the vessel.

  • Rheolitic thrombectomy – puncture of segments of the vessel to remove newly formed blood clots with catheters.

  • Aspiration – the blood clot is removed with a syringe connected to the clot. The method is easy to use, quickly performed, but with its help it is impossible to prevent the recurrence of thrombosis.

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