Limitations in the Feasibility of Pulmonary Embolectomy

Abstract

Of 101 patients who had major pulmonary emboli confirmed at autopsy, 44 died within 1 hour of the onset of symptoms; 26 had no abrupt change in the clinical course to indicate the presence of emboli; and three died while they were under anesthesia. Of the 28 patients who survived for more than 1 hour after onset of symptoms, seven had incurable malignant lesions, four were unconscious with irreversible brain damage, six were too ill from other diseases to undergo embolectomy, and the diagnosis was not suspected for five. Consequently, of the 101 patients only six would have been selected to undergo pulmonary embolectomy. Only by increasing our diagnostic acumen and by obtaining pulmonary angiograms as soon as possible after onset of symptoms can this salvage rate be improved.