What Is a Pulmonary Embolectomy?
A Pulmonary Embolectomy is a procedure to remove a blood clot (embolus) from the arteries in the lungs.
It is performed when a pulmonary embolism (PE), a serious blockage caused by a blood clot, prevents proper blood flow and puts strain on the heart.
This procedure helps restore circulation, improve oxygen levels, and prevent life-threatening complications. It may be performed surgically or through a catheter-based (endovascular) approach, depending on the severity and patient condition.
Why Is a Pulmonary Embolectomy Needed?
A pulmonary embolism can cause sudden breathlessness, chest pain, or even collapse if untreated.
When blood thinners or clot-dissolving medications (thrombolytics) are not effective or suitable, a pulmonary embolectomy may be needed to:
- Quickly remove a large or life-threatening clot
- Restore normal blood flow to the lungs
- Reduce strain on the heart
- Prevent long-term complications such as pulmonary hypertension
It is considered in urgent or emergency cases when a PE poses immediate risk to life.
What Causes a Pulmonary Embolism?
Most pulmonary embolisms occur when a blood clot forms in the deep veins of the legs, a condition known as Deep Venous Thrombosis (DVT), and travels through the bloodstream to the lungs.
Common risk factors include:
- Prolonged bed rest or immobility
- Recent surgery or trauma
- Smoking
- Cancer or cancer therapy
- Pregnancy and hormonal changes
- Clotting disorders or family history of DVT/PE
Recognising these risks early can help prevent pulmonary embolism before it becomes severe.
How Is a Pulmonary Embolectomy Performed?
The choice of technique depends on the size and location of the clot, as well as the patient’s stability.
1. Catheter-Directed (Endovascular) Pulmonary Embolectomy
- A thin catheter is inserted through a vein in the groin or neck.
- Using imaging guidance, the catheter is advanced to the blocked artery in the lungs.
- The clot is removed by suction, mechanical fragmentation, or targeted delivery of clot-dissolving medication.
- This minimally invasive approach is preferred for many patients due to shorter recovery time.
2. Surgical Pulmonary Embolectomy
- In rare cases where the clot is very large or catheter techniques are not possible, open surgery is performed.
- The surgeon directly removes the clot from the pulmonary artery under controlled conditions.
- This is usually reserved for emergency, life-threatening cases.
Is Pulmonary Embolectomy Safe?
Yes, when performed by experienced specialists, the procedure can be lifesaving.
As with all interventions, potential risks such as bleeding, vessel injury, or recurrence of clots are carefully managed through close monitoring and follow-up care.
Your doctor will evaluate the safest and most effective treatment based on your condition and overall heart health.
What Happens After the Procedure?
Patients are usually monitored in the hospital for a few days. Post-procedure care may include:
- Anticoagulant medications to prevent new clots
- Ultrasound screening to check for residual DVT
- Lifestyle guidance such as staying active and avoiding prolonged sitting
Recovery time depends on the severity of the original clot and the patient’s overall health.
How Can Pulmonary Embolism Be Prevented?
Prevention focuses on reducing clot formation and improving circulation:
- Move regularly during long flights or car rides
- Stay active and maintain a healthy weight
- Follow your doctor’s advice after surgery or hospitalisation
- Manage chronic conditions such as diabetes or high blood pressure
- Avoid smoking
If you’ve had a previous DVT or PE, your cardiologist may recommend lifelong preventive therapy.
Frequently Asked Questions (FAQs)
1. Is a pulmonary embolectomy always necessary for pulmonary embolism? No. Most pulmonary embolisms are treated with medication. Embolectomy is reserved for large or high-risk clots that do not respond to drugs.
2. How long does recovery take? Recovery varies by severity, but most patients improve within days to weeks with proper follow-up and medication.
3. Can the clot come back after removal? There is a small risk of recurrence, which is why ongoing anticoagulant therapy and regular monitoring are important.
4. Is catheter-based embolectomy safer than open surgery? Yes. The catheter approach is less invasive, requires smaller incisions, and has faster recovery times for suitable patients.
5. What are the long-term outcomes after embolectomy? With proper treatment and lifestyle management, most patients recover fully and maintain good heart and lung function.
