Treatment for an embolism depends on which type of embolism is present. Severe obstructions, such as those that occur with pulmonary embolism, can cause a person to collapse. Emergency hospital treatment is focused on keeping the patient breathing and maintaining circulation. The patient is typically treated for shock and given oxygen and anticoagulants. An embolectomy (surgery to remove the blockage) may be performed under general anesthesia. During an embolectomy, an incision is made into the affected artery, the embolus is sucked out by aspiration (suction). The incision is then closed with stitches (sutures) and/or surgical staples.

If the embolism is caused by a blood clot and surgery is not possible, or if the patient is stable and not in shock, then a thrombolytic drug (clot-buster) may be given along with an anticoagulant drug to prevent further clot formation. Clot-busting drugs are considered a vital part of treatment for strokes that are caused by blood clots. However, their use involves some risk of excessive bleeding and they may not be a suitable treatment method for all patients.

In the case of recurrent atrial emboli that are caused by atrial fibrillation, or an abnormal heart rhythm in the atria, physicians will usually prescribe an anticoagulant drug to be taken on a long-term basis.

Because pulmonary embolism is closely linked to deep vein thrombosis (DVT), physicians will try to prevent pulmonary embolism, by treating or preventing the DVT. Risk factors for DVT include cancer, obesity and heart failure. Those also at risk for DVT are elderly patients, people who have had surgery within the previous three months and those who have been immobile during the previous 30 days. DVT can be treated with blood-thinning drugs to prevent the formation of clots.

Patients with DVT who cannot tolerate anticoagulants may benefit from an infrequently used alternate treatment – a clot-trapping filter called a vena cava filter. The filter is inserted into the main vein leading from the legs to the heart and serves to stop large emboli from passing to the lungs. Researchers are working on developing a vena cava filter that can be removed after the threat of embolism has passed. There are some risks associated with permanent vena cava filters, including the potential for the filter to break down or fragment, dislodge, or even cause a blood clot themselves.

In treating a fat embolism, patients may be placed on a ventilator (e.g., a breathing machine). Aspirin or steroids may also be given to the patient in order to prevent further complications, such as DVT.

In the case of an air embolism, treatment consists of recompression in a hyperbaric chamber (a chamber that can increase atmospheric pressure) as soon as possible, oxygen administration and cautious rehydration.

Other embolisms are treated according to the size, nature and location of the obstruction. With severe embolisms, survival depends on the success of resuscitation attempts, the patient’s overall condition, the importance of the blood vessel being obstructed and the speed with which normal blood flow is reestablished. When the cause of the embolism can be diagnosed and treated early, the long-term outlook for the patient is good.