Having Surgical Thrombectomy

Surgical thrombectomy is surgery to remove a blood clot from one of your blood vessels. The blood clot may be in an artery or vein in your arm, leg, or another part of your body. It may block the flow of blood to or from your tissues or organs.

What to tell your healthcare provider

Tell your healthcare provider about all the medicines you take. This includes prescription and over-the-counter medicines, such as ibuprofen. It also includes vitamins, herbs, and other supplements. And tell your healthcare provider if you:

• Have had any recent changes in your health, such as an infection or fever

• Are sensitive or allergic to any medicines, latex, tape, or anesthesia (local and general)

• Are pregnant or think you could be

Tests before your surgery

You may have tests before the treatment. The tests may include:

• Ultrasound. This is done to help see a DVT (deep vein thrombosis) and measure the flow of blood in your leg.

• Venogram. This is done to get images of the blood clot and of your veins.

• CT scan. This is done to get more detailed images of the blood clot.

• MRI. This is done to get more detailed images of the blood clot.

• Blood tests. These are done to check your overall health and to check for blood clotting problems.

Getting ready for your surgery

Talk with your healthcare provider about how to prepare for your surgery. You may need to stop taking some medicines before the procedure, such as blood thinners and aspirin. If you smoke, you may need to stop before your surgery. Smoking can delay healing. Talk with your healthcare provider if you need help to stop smoking.

Also, make sure to do the following:

• Ask a family member or friend to take you home from the hospital. You can't drive yourself.

• Follow any directions you are given for not eating or drinking before procedure.

• Follow all other instructions from your healthcare provider.

You will be asked to sign a consent form that gives your permission to do the surgery and consent to be given anesthesia. Read the forms carefully and ask questions if something is not clear.

On the day of your surgery

Your surgery will be done by a doctor who is a blood vessel (vascular) specialist. It can be done in several ways. Ask your doctor about the details of your surgery. In general, you can expect the following:

• An IV (intravenous) line will be put in a vein in your arm or hand. You’ll receive fluids, medicines, and anesthesia through this IV.

• You may also get medicine to help you relax (sedation) or numbing medicine (local anesthesia).

• You may be given a blood thinner, such as heparin, to help stop blood clots from forming during surgery.

• The surgeon will make a cut (incision) through your skin and into the blood vessel with the clot. Continuous imaging may be used to help the surgeon see the blood vessel and clot.

• They will remove the clot and repair the blood vessel as needed.

• A thin tube (catheter) may be used to remove any part of the clot that remains. A small mesh tube (stent) may be put in the blood vessel to help keep it open.

• The surgeon will close the incision and then bandage it.

After your surgery

After the surgery, you will spend time in a PACU (post-anesthesia care unit). Your healthcare team will closely watch your heart rate, blood pressure, and breathing. You may be able to go home the same day. Your healthcare provider will tell you more about what to expect.

Recovering at home

Make sure you follow all of your healthcare provider’s instructions. This includes instructions about medicines, activity, and incision care.

After you go home, you may need to take medicines to help stop blood clots from forming. You may need to take them for a short time, or take them for a longer time. You may also need to take medicines to prevent clots before any future surgery. Your healthcare provider will let you know about any other changes in your medicines. You can take pain medicine at home if you need it, as directed. 

You can go back to your normal activities when you get home. But don't do any difficult activities or heavy lifting for several days. Your healthcare provider will give you more specific instructions about activity.

You may need to wear elastic (compression) stockings. The stockings help to keep your blood flowing. This may help stop clots from forming. If you smoke, you will need to stop. This will also help to prevent blood clots. Talk with your healthcare provider if you need help to quit smoking.

Follow-up care

Your healthcare provider may want you to have imaging tests of your blood vessels. Make sure to go to all of your follow-up visits.

When to call your healthcare provider

Call your healthcare provider right away if you have any of the following:

• Swelling or pain that gets worse

• Weakness or numbness near the area of your surgery

• Bleeding from the incision or other places

• Fever

• Symptoms of a blood clot. These include swelling, pain, warmth, and redness.

• Shortness of breath or trouble breathing

• Chest pain