Femoral re-embelectomy by Mr Hafizan, Mr Jazree, Dr Ikhwan

Findings
Pre operatively no flow from SFA and common iliac artery
Embolectomy done up till distal aorta with Fogarty ballon size 6
Long segment thrombus noted - successfully thrawled with 2 attempts
Emoblectomy done into SFA using ballon size 6 and 4
- multiple mid-long length thrombus retrieved after multiple attempts of thrawling
Post operative good flow from profunda, common iliac and SFA

Vascular assessment post op Right LL

Femoral 2+
Popliteal NP Triphasic
DPA NP NS
PTA NP NS

Procedure
Patient was placed in supine position under GA
Area cleaned and draped
Heparin 3000units given stat intraoperatively
Previous sutures incised
Femoral artery identified
Vessel loop applied proximally and distally
Debakey clamp applied
Arteriotomy done with Blade size 11
Embolectomy done up till distal aorta , retrograde into profunda and SFA with
Fogarty balloon size 4/6
Arteriotomy puncture closed continuously with patch and Prolene 70
Hemostasis secured
Subcutaneous closed continuously with Ecosorb 2/0
Skin closed with monosyn 4/0
Dressing applied

Plan
Continue IVI heparin infusion 7ml/hr
- adjust accordingly to heparin protocol
4 hourly vascular charting
Keep IV drip 6 pint NS/24hours
Allow orally once fully conscious
Continue analgesia
Keep CBD
Vital signs monitoring and hourly urine output monitoring
Watch out for reperfusion syndrome