Popliteal embolectomy: does it still have a role?

The failure of a femoral embolectomy presents a difficult problem. The role of popliteal embolectomy in the subsequent management is still not clear. A study of 12 patients who underwent a secondary popliteal embolectomy is reported. Nine of the 12 patients had successful results in terms of limb salvage. The question that has to be addressed is the role of popliteal embolectomy as opposed to thrombolysis. Recent studies tend to favour the latter approach. It is concluded that if an embolectomy catheter will not pass or will not clear the distal segment, the surgeon should consider intraoperative thrombolysis or popliteal embolectomy prior to embarking on a bypass procedure.