General Surgery

Femoral Embolectomy

OPERATION: Femoral Embolectomy (Right / Left)
ANAESTHETIC: General / regional / local anaesthesia
URGENCY: Emergency — acute limb ischaemia
POSITION: Supine

INDICATION:
Acute [right / left] lower limb ischaemia secondary to embolic occlusion. [Onset, limb status: viable / threatened / irreversible].

PROCEDURE:
WHO Checklist performed. Groin prepared and draped. Longitudinal incision over the common femoral artery. Dissection through subcutaneous tissue. Common femoral artery, superficial femoral artery, and profunda femoris identified, controlled with slings and vessel loops.

IV heparin administered [5000 IU].

Transverse arteriotomy in common femoral artery at the bifurcation. Embolus retrieved. Fogarty catheter [size 4 / 5F] passed proximally — back-bleeding confirmed after proximal thrombectomy. Fogarty catheter passed distally into the superficial femoral artery to appropriate depth and balloon inflated on withdrawal — thrombus / embolus retrieved × [passes]. Process repeated in profunda femoris. Pulsatile distal backflow confirmed. [On-table angiogram performed if incomplete clearance].

Heparinised saline flush. Arteriotomy closed with continuous 5/0 Prolene, Dacron patch applied [if vessel small].

Clamps released. Femoral pulse confirmed. Limb assessed — [describe perfusion, Doppler signals distally].

FINDINGS:
Embolus / thrombus retrieved from [vessels]. [Fresh / organised] clot [length, description]. Final angiogram: [satisfactory clearance / residual thrombus managed with further passes / intraoperative thrombolysis].

EBL: [Volume] ml. COMPLICATIONS: None [/ describe].

POST-OPERATIVE INSTRUCTIONS:
Anticoagulation commenced — reason for embolus investigated. Limb monitoring Q1H observations. Vascular surgical review. Echocardiogram / cardiac monitoring if cardiac source suspected.