Surgery

Surgical removal of a clot is called an embolectomy. This type of treatment for pulmonary embolism is rarely used. It is considered for people who can't have other kinds of treatment or those whose clot is so dangerous that they can't wait for medicine to work. An embolectomy also may be an option for a person whose condition is stable but who shows signs of significant reduced blood flow in the pulmonary artery.

What to think about

Surgery increases the risk of forming new blood clots that can cause another pulmonary embolism.

Other Treatment

Some people cannot take anticoagulant medicines, or they continue to develop blood clots despite taking the medicines. If surgery or medicines are not options, other methods of preventing pulmonary embolism may be considered, such as a vena cava filter.

Other treatment choices

A vena cava filter may be inserted in the large central vein that passes through the abdomen and returns blood from the body to the heart (vena cava). This filter can prevent blood clots in the leg or pelvic veins from traveling to the lungs and heart. These filters may be permanent or removable.

Studies have shown that vena cava filters help prevent pulmonary embolism. But they may be most effective when combined with anticoagulant therapy.

What to think about

Vena cava filters are not recommended as the first treatment for pulmonary embolism. But they may be considered if you:

• Continue to have pulmonary embolism despite taking anticoagulant medicine.
• Cannot take anticoagulants because of bleeding risk.
• Have an increased risk of death or a severely restricted lifestyle should another pulmonary embolism occur.

Vena cava filters may benefit people who have had a pulmonary embolism surgically removed (embolectomy) if another pulmonary embolism would likely be fatal or severely limit a person's lifestyle.

Vena cava filters can cause serious health problems if they break or become blocked with one or more blood clots.

Vena cava filters have not been shown to lower the death rate in people with pulmonary embolism.