Having Surgical Thrombectomy

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 test is done to help see a DVT (deep vein thrombosis) 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.

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 the procedure.

• Follow all other instructions from your healthcare provider.

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.

On the day of your surgery

Your surgery will be done by a healthcare provider who is a blood vessel (vascular) specialist. It can be done in several ways. Ask your provider 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. 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.

• 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 your healthcare provider’s instructions. This includes instructions about medicines, activity, and wound care. Never skip or change a dose of your medicine. Call your healthcare provider or your pharmacist if you have questions about your medicines.

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. Always tell new healthcare providers about your history of blood clots. 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 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 of 100.4°F (38°C) or higher, or as advised by your healthcare provider.

• Symptoms of a blood clot, such as swelling, pain, warmth, and redness

• Shortness of breath or trouble breathing

• Chest pain ( call 911)