General Information

DEFINITION--Removal of a blood clot (embolus) that has blocked blood supply to the leg and foot.

BODY PARTS INVOLVED--Blood vessel in the leg that is called the femoral artery below the groin and the popliteal artery behind the knee; the heart is the usual source of the blood clot.

REASONS FOR SURGERY--Restoration of normal blood circulation in the legs. Re-establishing blood flow can restore muscular function, prevent gangrene and enable patients to return to normal or almost normal activities.

SURGICAL RISK INCREASES WITH

• Obesity.
• Smoking.
• Rheumatic heart disease or coronary-artery disease.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; narcotics; beta-adrenergic blockers; or cortisone.

What To Expect

WHO OPERATES--General surgeon or vascular surgeon.

WHERE PERFORMED--Outpatient surgical facility or hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; arteriogram (See Glossary).
• During surgery: Arteriogram after blood clot is removed.
• After surgery: Blood studies; heart studies, such as sonogram (See Glossary).

ANESTHESIA--Spinal anesthesia by injection.

DESCRIPTION OF OPERATION

• An incision is made over the artery where the clot is lodged.
• The artery is clamped above and below the blood clot.
• The artery is opened above the blood clot.
• A special catheter is passed into the artery beyond the blood clot. The catheter is expanded with air beyond the clot and then withdrawn, forcing the clots out of the artery.
• An anticoagulant is injected into the artery, and normal blood circulation is restored.
• The clamps are removed from the arteries. Muscles and connective tissue are sewn together in layers. The skin is closed with sutures or clamps, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Inadvertent injury to the large nerves.
• Recurrent blood clot.

AVERAGE HOSPITAL STAY--0 to 3 days.

PROBABLE OUTCOME--Expect complete healing without complications. Allow about 3 weeks for recovery from surgery.

Postoperative Care

> Move and elevate legs often while resting in bed to decrease the likelihood of deep--vein blood clots.

> You may use non--prescription drugs, such as acetaminophen, for minor pain.

ACTIVITY

• Resuming daily activities, including work, as soon as you are able can help the healing process.
• Avoid vigorous exercise for 3 weeks after surgery, but start a walking exercise program as soon as your doctor recommends.
• Resume driving about 1 week after returning home.

DIET---No special diet.

Call Your Doctor If

> Pain, swelling, redness, drainage or bleeding increases in the surgical area.