Thrombectomy Surgery in Delhi

Indications

Thrombectomy surgery is typically indicated in the following situations:

• Arterial Thrombosis: Blood clot obstructing an artery, leading to reduced blood flow and tissue ischemia.
• Deep Vein Thrombosis (DVT): Clot formation in a deep vein, commonly in the legs, which can potentially lead to pulmonary embolism if the clot dislodges and travels to the lungs.
• Acute Limb Ischemia: Sudden blockage of blood flow to a limb, which is a medical emergency requiring immediate intervention to prevent tissue death (gangrene).

Types of Thrombectomy

Several techniques and approaches may be used for thrombectomy, depending on the location and nature of the clot:

1. Surgical Thrombectomy:
   • Open Surgery: A direct surgical approach where an incision is made over the affected blood vessel, and the clot is removed manually with instruments.
   • Endarterectomy: Removal of the inner lining of an artery where the clot is located.
2. Catheter-Directed Thrombectomy (CDT):
   • Mechanical Thrombectomy: Using catheters with devices such as thrombectomy balloons, rotating wires, or suction devices to physically remove the clot.
   • Pharmacomechanical Thrombectomy: Combination of mechanical devices and thrombolytic drugs (clot-dissolving medications) delivered directly to the clot site.
3. Percutaneous Thrombectomy:
   • Minimally invasive procedure performed through a small puncture in the skin, using catheters and specialized tools to access and remove the clot under imaging guidance (such as ultrasound or fluoroscopy).

Procedure Steps

1. Preoperative Evaluation:
   • Imaging studies (such as ultrasound, CT angiography, or magnetic resonance angiography) to locate and assess the size and extent of the clot.
   • Blood tests to evaluate clotting factors and overall health status.
2. Anesthesia:
   • General anesthesia or regional anesthesia (depending on the location and extent of the thrombosis) to ensure patient comfort and safety during the procedure.
3. Access and Intervention:
   • Access to the blood vessel is gained through a surgical incision or percutaneous approach.
   • Catheters with appropriate devices or techniques are used to reach the clot site.
   • The clot is then mechanically disrupted, dissolved with medications, or extracted depending on the chosen method.
4. Closure and Postoperative Care:
   • Closure of the incision site with sutures or closure devices.
   • Monitoring of vital signs and circulation postoperatively to ensure adequate blood flow to the affected area.
   • Prevention of complications such as bleeding, infection, or recurrence of thrombosis.
   • Rehabilitation and physical therapy as needed to restore function and mobility, especially in cases of acute limb ischemia.

Postoperative Care and Recovery

• Hospital Stay: Length of hospitalization varies depending on the complexity of the procedure and the patient’s overall health.
• Medications: Anticoagulant medications may be prescribed to prevent further clot formation.
• Follow-Up: Regular follow-up visits to monitor recovery, assess blood flow, and adjust medications as needed.
• Lifestyle Modifications: Recommendations for lifestyle changes, such as smoking cessation and managing underlying conditions (like diabetes or hypertension) to reduce the risk of future thrombotic events.

Risks and Complications

• Bleeding: Risk of bleeding at the surgical site or internally.
• Infection: Risk of infection at the incision site or in the bloodstream.
• Vascular Injury: Damage to blood vessels during the procedure.
• Recurrence: Possibility of clot recurrence, especially if underlying risk factors are not addressed.

Conclusion

Thrombectomy surgery is a critical intervention for restoring blood flow in cases of arterial or venous thrombosis, preventing tissue damage and potentially life-threatening complications like pulmonary embolism or limb loss. Advances in minimally invasive techniques have improved outcomes and reduced recovery times for many patients undergoing thrombectomy. Early diagnosis, prompt intervention, and comprehensive postoperative care are essential for optimizing outcomes and reducing the risk of recurrence in individuals affected by thrombotic conditions.