Embolism

Under embolism [ ɛmboli ː ] ( from Greek: ἐμβάλλω (pronounced emballo ) = throw and embolus: Gefäßpfropf ) is understood in medicine the partial or complete blockage of a blood vessel by is flooded with the blood material. These include endogenous and exogenous substances such as fat drops, blood clots and air bubbles.

Classification

Embolism can be divided:

• The cause: Thromboembolism ( a blood clot Einschwemmen )
• Fat embolism ( Wash in fat droplets, eg by large, open fractures)
• Gas or air embolism ( after injection of air or gas bubble formation at rapid emergence from a great depth, see diving or decompression sickness, in veterinary medicine: gas bubble disease of fish)
• Tumor embolism ( blockage of blood vessels by tumor tissue)
• Amniotic fluid embolism (birth complication )
• A bacterially infected embolus is also called septic embolus.
• Cholesterol embolism ( not synonymous with fat embolism): most of ruptured plaques of the arterial wall

• Pulmonary embolism ( = venous embolism): The embolus originates from the body veins and clogged after passage of the heart lung arteries.
• Arterial embolism embolus comes from the heart or large arteries and clogged arteries (eg, stroke, mesenteric infarction, occlusion of a leg artery Retinal Artery Occlusion )
• Paradoxical embolism ( = crossed embolism): embolus originates from the veins and clogged arteries ( apart from the pulmonary artery ). Only possible with passage of the thrombus ( foramen ovale ) through an open atrial septum.
• An embolus, which depends on a vessel branching ( bifurcation ) is referred to as horseback embolus.

Most emboli are the thromboembolism after deep vein thrombosis (pulmonary embolism ), and thromboembolism in the arteries of the brain ( stroke). In Germany, 20,000 to 25,000 people die every year from an embolism.

Prophylaxis

Thrombosis can patients at risk by prophylactic subcutaneous injection of heparin, now mostly low molecular weight heparin or mainly by physical measures such as early mobilization, intermittent compression or anti -thrombosis stockings (ATS ) are avoided. Heparins are administered in high-risk patients, physical prophylaxis is indicated in all risk groups. See also the AWMF S2 guideline for inpatient and outpatient thromboembolism prophylaxis, which has been ratified by 20 operating medical professional groups.

Therapy

Emboli arising from thrombi can be dissolved under certain circumstances with drugs ( thrombolysis ). Occasionally, a surgery to remove the embolus necessary ( embolectomy ).