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Dr.Ashish Ambhore1st floor Bhawani Chambers Ajni Square, Wardha road

Pulmonary Embolism

TREATMENTS

What is pulmonary embolism?

Pulmonary embolism occurs when aclotobstructs the pulmonary vasculature causing decreased blood flow to the lungs. Usually a blood clot travels from elsewhere in the body, such as the legs, to the right side of the heart, and then to the arteries that supply the lungs. The strain on the right side reduces the amount of blood that the left side of the heart can pump to the rest of the body, causing dangerously low blood pressure.

Sign & Symptoms

  • Breathlessness
  • Chest pain ( more on breathing in)
  • Rapid heart rate
  • Rapid breathing
  • Abnormally low blood pressure
  • Low blood oxygen levels
  • Sudden death

Risk Factors

  • Cancer
  • Prolonged bed rest
  • Smoking
  • Stroke
  • Estrogen based drugs
  • Pregnancy
  • Obesity
  • Genetic conditions

Role of Surgery

Although surgical resection may be curative for those individuals with focal disease, most patients presenting with major hemoptysis have diffuse chronic lung disease and limited pulmonary reserves
Surgical intervention is hazardous and often impossible in these patients with diffuse parenchymal lung disease.

Investigation

  • D-dimer assay
  • CT pulmonary angiography
  • Lung ventilation perfusion scan

Management

Systematic anticoagulation is used to prevent a new clot from forming. It is often the only treatment for those with a low-risk pulmonary embolism.

These procedures are less risky, less painful, andrequire less recovery time than traditional surgery.

Catheter Directed Thrombolysis

This technique restores blood flow to the lung thus reducing the strain on the right side of the heart. A small cut is made either on the neck or the thigh to access a vein and small catheters and wires are guided to the heart and to the right and left pulmonary arteries till the desired clot is reached and a protein to dissolve the clot is released causing the clot to break down. The catheter is left in place for a period of 12- 24 hrs and removed after the desired effect is achieved.

Mechanical Thrombectomy

It is used for patients who cannot receive catheter-directed thrombolysis. Using the same method as in catheter-directed thrombolysis, a suction device is placed into the pulmonary artery as close to the clot as possible and high-power suction is used to remove the clot.