Surgical Thrombectomy: Before Your Surgery

What is 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.

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 intravenous (I.V.) line will be put in a vein in your arm or hand. You’ll receive fluids, medicines, and anesthesia through this I.V.
• 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. This medicine helps 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.
• The surgeon 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.

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

• Ultrasound. This test is done to help see a deep vein thrombosis (DVT) and measure the flow of blood in your leg.
• Venogram. This test is done to get images of the blood clot and of your veins.
• CT or MRI scan. These tests are 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.

How do you prepare for surgery?

• Tell your doctor 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 doctor 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.
• Talk with your doctor 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 doctor if you need help to stop smoking.
• 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 the procedure.
• Follow all other instructions from your doctor.
• You will be asked to sign consent forms. These give your permission to do the surgery and get anesthesia. Read the forms carefully and ask questions if something is not clear.

What happens on the day of surgery?

Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.

• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no surgical site errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.

When should you call for help?

• You have questions or concerns.
• You don't understand how to prepare for your surgery.
• You become ill before the surgery (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about having the surgery.