Recently, under the leadership of Professor Zhou Zhaoxiong, an expert in Tibet assistance from Shanghai Renji Hospital, and under the guidance of Dr. Ma Xiaoyun from the Department of Radiology, the emergency physician of our hospital successfully provided a patient with “acute pulmonary embolism” in the emergency EICU of our hospital. , left lower extremity venous thrombosis”, the first “inferior vena cava filter implantation” operation in Shigatse area.
Figure 1: Director Zhou Zhaoxiong and Dr. Ma Xiaoyun, experts in Tibet aid Implantation surgery
A 44-year-old male patient came to the emergency department of our hospital because of chest pain. Treatment: Director Chen Liang, a Tibet-aiding expert from the emergency department of our hospital, and Director Solan Pianduo of the emergency department instructed the ward rounds: the patient is in a hypercoagulable state. If the lower extremity thrombosis is not treated, the patient may experience severe complications such as acute pulmonary embolism again once it falls off. Symptoms, immediately contact Director Zhou Zhaoxiong for consultation with Dr. Ma Xiaoyun, to determine whether the “inferior vena cava filter implantation” can prevent and solve the related complications of the patient’s lower extremity thrombosis; Director Zhou Zhaoxiong, Director Chen Liang, Director Suolang Pianduo, and Dr. Ma Xiaoyun After a joint analysis and discussion of the patient’s condition, it was considered that the patient was suitable for “inferior vena cava filter implantation”; and after a detailed surgical plan was formulated, the patient was operated in a timely manner.
Surgical process: After the preparations were completed, the inferior vena cava filter was implanted under DSA. The filter was released at a position 2 cm below the bilateral renal veins. After the release, angiography was performed again. The arterial sheath was withdrawn for hemostasis compression.
The patient improved and was discharged after two days of observation in the emergency EICU of our hospital.
Figure 2: Dr. Gao Zhan in the emergency department on the same stage Assisted, observed and assisted by Dr. Dawa Tsering in emergency department, and assisted by Dong Baohui of the technical team
Figure 3: Preimplantation Angiography
Figure 4: Filter successfully implanted
Vena Cava Filter: It is a medical filter, which is a filtering device designed to prevent pulmonary embolism from falling off in the superior and inferior vena cava system, and preventing the occurrence of fatal pulmonary embolism.
Pulmonary embolism: It is an emergency with high clinical morbidity and mortality. In the United States, the number of symptomatic pulmonary embolism cases is 570,000 to 630,000 each year, of which 200,000 lead to death. Coagulation therapy can achieve some curative effects, but there are still 3-20% of re-pulmonary embolism, and anticoagulation therapy itself has 26% complications, of which 5-12% are fatal complications; some patients cannot receive anticoagulation therapy, Such as acute bleeding, peptic ulcer, primary or metastatic tumor (especially intracranial tumor), pregnancy, before surgical treatment, etc.
