embolien

Embolien are emboli—the plural form in German—referring to substances that travel through the bloodstream and may occlude vessels, producing an embolism. They can be solid, liquid, or gaseous. Common types include thromboemboli (originating from clots), fat emboli, air (gas) emboli, and septic emboli derived from infectious material.

Most emboli originate at a distant site and enter the circulation, traveling until they lodge in a vessel too small to permit passage. Vessel occlusion interrupts blood flow, causing ischemia in the affected tissue and, if sustained, infarction. The lungs are a frequent target of venous emboli, producing pulmonary embolism; arterial emboli, often from the heart or great vessels, can cause stroke, myocardial infarction, or infarctions in the kidney, spleen, and other organs.

Diagnosis usually relies on imaging such as CT pulmonary angiography for suspected pulmonary embolism or duplex ultrasound and other vascular imaging for peripheral emboli; blood tests (for example, D-dimer) may support suspicion but are not definitive. Treatment depends on the location and severity: stabilization, anticoagulation (typically heparin followed by oral anticoagulants), and, in selected cases, thrombolysis or mechanical thrombectomy. Gas emboli or septic emboli may require specific therapies.

Risk factors for embolism include atrial fibrillation, recent surgery or trauma, cancer, immobilization, and hypercoagulable states. Prevention focuses on risk-factor management and prophylactic anticoagulation in high-risk situations; in certain cases, venous filters may be used to trap emboli from the systemic venous circulation.