Embolectomy / Thrombectomy

SOC → SCF-DBI Logic Translation

Purpose

Embolectomy and Thrombectomy are vascular interventions performed to remove intravascular occlusions caused by emboli or thrombi in order to restore blood flow, reverse ischemia, preserve tissue viability, and prevent irreversible organ or limb injury.

These procedures may be performed through:

• Open surgical techniques
• Catheter-directed techniques
• Mechanical thrombectomy systems
• Hybrid vascular approaches

SOC Definition

Clinical Objective

Restore vessel patency by:

• Removing thrombus
• Removing embolic material
• Re-establishing perfusion
• Preventing tissue necrosis
• Preventing organ dysfunction
• Preserving functional viability

Common Indications

Acute Limb Ischemia

• Arterial thrombosis
• Embolic occlusion
• Graft thrombosis

Mesenteric Ischemia

• Superior mesenteric artery occlusion
• Acute visceral ischemia

Renal Ischemia

• Renal artery embolism
• Renal artery thrombosis

Upper Extremity Ischemia

• Brachial artery embolism
• Traumatic thrombosis

Hybrid Trauma Reconstruction

• Thrombosed repair
• Distal embolization
• Occluded shunts

SCF-DBI Translation

Core Concept

SOC views Embolectomy/Thrombectomy as:

Mechanical removal of an intravascular obstruction.

SCF-DBI views Embolectomy/Thrombectomy as:

Restoration of Dynamic Perfusion Continuity Following Acute Flow Interruption.

The true pathology is not the clot itself.

The pathology is interruption of the entire:

1. Perfusion network
2. Endothelial signaling system
3. Oxygen delivery pathway
4. Microvascular ecosystem
5. Organ viability platform
6. Recovery potential architecture

SCF-DBI Acute Occlusion Architecture

Domain 1

Acute Perfusion Interruption Mapping

SOC Focus

Remove the clot.

SCF-DBI Focus

Characterize the physiologic consequences of flow interruption.

Occlusion Cascade

Embolus or thrombus

↓

Flow obstruction

↓

Distal hypoperfusion

↓

Microvascular dysfunction

↓

Cellular hypoxia

↓

Metabolic failure

↓

Tissue injury

↓

Organ or limb loss

SCF Classification

Acute Perfusion Interruption Syndrome (APIS)

A regional ischemic collapse state caused by sudden interruption of vascular flow.

Output

Perfusion Interruption Severity Score (PISS)

Domain 2

Thromboinflammatory Surveillance

Major SCF-DBI Enhancement

Selected Enhancement:

Thromboinflammatory Surveillance

This becomes the principal SCF-DBI enhancement for Embolectomy/Thrombectomy.

Rationale

SOC evaluates:

• Clot removal
• Vessel patency
• Pulse restoration

SCF-DBI evaluates:

Persistence of the Thromboinflammatory State

because successful clot extraction does not necessarily terminate:

• Endothelial activation
• Inflammatory signaling
• Microvascular dysfunction
• Re-thrombosis risk

Thromboinflammatory Cascade

Occlusion

↓

Endothelial activation

↓

Platelet activation

↓

Inflammatory mediator release

↓

Microvascular dysfunction

↓

Re-occlusion risk

Assessment Domains

Surveillance States

Output

Thromboinflammatory Stability Index (TSI)

Domain 3

Reperfusion Recovery Intelligence

SCF-DBI Enhancement

Restoration of blood flow introduces a second physiologic challenge:

Reperfusion Stress

Assessment Domains

Output

Reperfusion Recovery Score (RRS-E/T)

Domain 4

Endothelial Recovery Surveillance

SCF-DBI Enhancement

Endothelial recovery determines long-term patency.

Assessment Domains

Output

Endothelial Recovery Score (ERS-E/T)

Domain 5

Microvascular Recruitment Mapping

SCF-DBI Enhancement

Large-vessel patency does not guarantee microvascular recovery.

Assessment Domains

Output

Microvascular Recruitment Index (MRI-E/T)

Domain 6

Organ/Limb Viability Preservation

SCF-DBI Enhancement

The objective is preservation of function, not simply flow.

Assessment Domains

Output

Viability Preservation Score (VPS)

Domain 7

Re-Occlusion Prevention Intelligence

SCF-DBI Enhancement

Successful thrombectomy is vulnerable to recurrence.

Assessment Domains

Output

Re-Occlusion Risk Index (RORI)

RHENOVA Integration

R1 — Survival Preservation

Restore:

• Vessel patency
• Tissue perfusion
• Oxygen delivery

Output:

Perfusion Rescue Status

R2 — Recovery Optimization

Reduce:

• Ischemic burden
• Reperfusion injury
• Microvascular dysfunction

Output:

Recovery Readiness Score

R3 — Endothelial Preservation

Protect:

• Glycocalyx integrity
• Microvascular architecture
• Flow stability

Output:

Endothelial Preservation Profile

R4 — Functional Restoration

Achieve:

• Organ salvage
• Limb salvage
• Durable perfusion

Output:

Perfusion Restoration Matrix

R5 — Long-Term Resilience

Prevent:

• Re-thrombosis
• Re-embolization
• Chronic ischemia
• Functional decline

Output:

Perfusion Resilience Profile

SCF-DBI Embolectomy / Thrombectomy Workflow

Step 1

Identify acute vascular occlusion.

Output

Perfusion Interruption Severity Score

Step 2

Perform embolectomy or thrombectomy.

Output

Flow Restoration Confirmation

Step 3

Activate Thromboinflammatory Surveillance.

Output

Thromboinflammatory Stability Index (TSI)

Step 4

Assess reperfusion recovery.

Output

Reperfusion Recovery Score

Step 5

Evaluate endothelial recovery.

Output

Endothelial Recovery Score

Step 6

Map microvascular recruitment.

Output

Microvascular Recruitment Index

Step 7

Assess organ or limb viability.

Output

Viability Preservation Score

Step 8

Determine re-occlusion risk.

Output

Re-Occlusion Risk Index

Glossary

SCF Principle Alignment

INDEX

SCF-SURG-EMBOLECTOMY-0001

SCF-SURG-THROMBECTOMY-0001

SCF-DBI-ACUTE-PERFUSION-INTERRUPTION-SYNDROME-0001

SCF-DBI-THROMBOINFLAMMATORY-SURVEILLANCE-0001

SCF-DBI-THROMBOINFLAMMATORY-STABILITY-INDEX-0001

SCF-DBI-MICROVASCULAR-RECRUITMENT-INDEX-0001

SCF-DBI-RE-OCCLUSION-RISK-INDEX-0001

SCF-VASCULAR-REPERFUSION-WORKFLOW-0033

SCF-EMBOLECTOMY-THROMBECTOMY-MASTER-0001