Surgical embolectomy in pulmonary embolism is indicated in:
a) Impending paradoxical systemic embolism
b) Hypotension with contraindication for thrombolysis
c) Failed thrombolysis
d) All of the above
Correct answer: d) All of the above
By impending paradoxical systemic embolism, it is meant that a thrombus in transit has been caught in the patent foramen ovale and is extending to both atria.
1. Myers PO, Bounameaux H, Panos A, Lerch R, Kalangos A. Impending paradoxical embolism: systematic review of prognostic factors and treatment. Chest 2010; 137 (1): 164-70.