Embolectomy
Key Points: Embolectomy
What is it?
The main artery running down your bad leg is blocked near the knee. The leg is starved of blood. This causes pain, infection and even loss of the limb. The blockage in the artery is because of a blood clot. This has formed in the artery, or has floated down in the bloodstream from your heart or another blood vessel upstream. The loose type of blood clot is called an embolus. Either way, it is essential to try and get the blood clot out. Taking out the clot is called an embolectomy.
If the clot came from upstream, and the leg is healthy, the operation usually works very well. If not, the artery may well clot up again, and the leg is at risk of getting worse. You may need special tests and possibly bigger operations. As a first step, the embolectomy is absolutely necessary to save your leg.
The Operation
You may have a general anaesthetic and be asleep for the whole operation, or have an injection in your back, (epidural) or groin and be heavily sedated. Either way you will not remember anything about the operation. A cut is made into the skin in the groin and thigh. Sometimes a cut is made on each side to catch any clot slipping into the artery of the other leg. The artery is opened. Then a special plastic balloon is slid down the artery. The clot is then pulled out through the opening in the artery. The opening in the artery is stitched up. The surgeon checks the blood is flowing down the artery once more. Finally the skin is stitched up.
If the operation is not done soon after the blocking (occlusion) of the artery it might be that the surgeon will have to make a couple of cuts on the skin and the underling fat and supportive tissue (fascia) on each side of your leg below the knee. The cuts are called fasciotomies. This is done because the leg gets very swollen when the blood flows through it again (perfusion) after a long time of non-perfusion. The swelling can compress the tissues of the leg to the point that it will destroy them. The fasciotomies release the pressure and allow the leg to recover. In most cases, the fasciotomies heal on their own relatively quickly and the areas of the cuts are covered again with skin.
You should plan to leave the hospital about five to seven days after the operation provided the leg is healthy. If you have fasciotomies you might need to stay longer.