Thrombolysis is not thrombolysis, whether it is thrombectomy or other measures, all need to wait for the angiography results to be considered.
Pulmonary emboli generally occur in the left and right main pulmonary arteries and their inferior branches. Distal stubborn pulmonary emboli are rare. Due to the strong autolytic ability of the thrombus in the terminal circulation of the pulmonary artery, the small thrombus at the terminal can be completely autolyzed by the human blood vessels, and doctors do not need excessive thrombolysis. The doctor only needs to open the main artery.
With this idea as a guide, it is like performing a coronary angiography at the root of the main blood vessel. The doctor wants to let the contrast agent reach the pulmonary artery at the root of the left pulmonary aortic trunk and the right pulmonary aortic trunk, usually in the inferior vena cava.
The inferior vena cava collects systemic venous blood into the right atrium. The venous blood from the right atrium is pumped into the right ventricle, and the venous blood is output from the right ventricle to the pulmonary artery, from the pulmonary artery to the left and right pulmonary artery trunks to the lungs for gas exchange, turning the venous blood into arterial blood, and then the pulmonary vein returns to the left atrium to The left ventricle pumps out throughout the body in a cycle called the pulmonary circulation.
Pulmonary arteries flow venous blood instead of arterial blood, and arterial blood flows through the pulmonary veins. The venous flow of the systemic circulation is the venous blood and the arterial flow is the arterial blood. This is the most misunderstood thing for the layman. Therefore, pulmonary artery thrombolysis dissolves venous thrombosis and penetrates the femoral vein instead of the femoral artery, which is different from coronary angiography.
Is enough to illustrate the complexity and variety of interventional procedures.
The doctors in the control room watched the imaging results together with the surgeons in the operating room through the lead glass and witnessed the real-time progress of the operation.
After the imaging machine is turned on, a thin wire can be seen coming to the lower end of the lung. Similar to coronary angiography again, the doctor at the end of the catheter must try to prevent the catheter from slipping out and wrap it around like a small hook. Today is not a young doctor's practice. The deputy high-level surgeon is obviously different. The speed is super fast. During the period, there will be no hesitation due to unskilled exploration of the anatomical position of the human body.
Most people don't see the process clearly. Da Da, the contrast agent has been injected into the blood vessel to develop.
The principle is exactly the same as other interventional procedures. Where the blood vessel is blocked, if the contrast agent cannot pass through, a contrast loss will appear as a blank, that is, it will not turn black or white. In the pulmonary artery, left and right pulmonary trunk thrombus blocked the lack of pulmonary arterial imaging, it is possible that the imaging of a unilateral pulmonary artery is all dull. The visual effect on the display is amazing, perhaps even more shocking than the coronary angiogram looks.
First of all, under normal development of blood vessels, the pulmonary vascular system is the same as the blood vessels distributed on other human organs, just like the branches of a big tree, but the size and number are different.
That is to say, the difference in the visual effect to the doctor after the contrast agent is shot is very obvious. It can be seen on the screen that the two thick-diameter sewer pipes on the left and right seem to have blood vessels coming out of the head, and the black thread like a feather duster is the pulmonary artery system. The blood vessel distribution map produced by coronary angiography does not have such a terrible density.
The normal angiography is like this. Once the blockage occurs, if it is a unilateral active trunk blockage of the lung, it is not unexpected, it can be a magnificent scene where the feather duster on one side is completely dimmed. Enough to make medical students see and feel taught. This may not be very similar to coronary angiography. The lack of blood vessels displayed by coronary angiography is like a blank segment of the line in the previous operation.