Whether to dissolve the thrombus or not, whether to remove the thrombus or take other asures, all require waiting for the angiography results before considering.
Pulmonary embolism generally occurs in the main trunks of the left and right pulmonary arteries and their branches. Distal stubborn pulmonary embolism is relatively rare. Due to the strong self-dissolving ability of thrombosis in the terminal circulation of pulmonary arteries, small terminal thrombi can be completely self-dissolved by the body’s vessels without the need for excessive thrombolysis by doctors. Doctors only need to unblock the main artery trunk.
With this guiding idea, it is akin to heart coronary angiography which targets the roots of major vessels. Doctors need to ensure the contrast agent reaches the root of the left and right pulmonary artery trunk, generally by injecting it into the inferior vena cava.
The inferior vena cava collects venous blood from the entire body and enters the right atrium. Venous blood from the right atrium is pushed into the right ventricle, then outputs from the right ventricle to the pulmonary artery, from the pulmonary artery to the left and right pulmonary artery trunks, and to the lungs for gas exchange, transforming venous blood into arterial blood, then returning via the pulmonary veins to the left atrium and to the Left Ventricle to be pumped to the whole body, this cycle is called Pulmonary circulation.
The pulmonary artery carries venous blood rather than arterial blood, whereas pulmonary vein blood is arterial blood. In systemic circulation, veins carry venous blood and arteries carry arterial blood. This is sothing that outsiders often misunderstand. Therefore, pulmonary artery thrombolysis targets venous thrombi, and uses the femoral vein rather than the femoral artery, which is different from coronary angiography.
This sufficiently illustrates the complexity and variety of interventional surgeries.
Doctors in the control room watched the angiography results through lead glass along with the surgical doctors in the operating room, witnessing the real-ti progress of the surgery.
After the angiography machine started, a thin line of tubing could be seen reaching the lower end of the lung. Similar to coronary angiography once again, doctors needed to figure out how to avoid the catheter sliding out and maneuver it as if it had a small hook at the end. Today was not a practice for young doctors; the deputy chief surgeon commanded the operation, which was evidently different, with ultra-fast speed, without hesitation due to unfamiliarity in exploring human anatomical positions.
Most people could not clearly see the process. Click-clack, the contrast agent was injected into the vessel for imaging.
Following the sa principle as other interventional surgeries, at the site of vascular blockage, the contrast agent cannot pass through, forming an angiographic void represented by a blank space, which changes from black to white. In the pulmonary artery, thrombosis in the left and right pulmonary artery trunks blocking the pulmonary artery may result in one side of the pulmonary artery’s imaging appearing completely dull. This visual effect on the display screen is quite astonishing, potentially even more striking than coronary vascular angiography.
To start with normal imaging of unobstructed vessels, the pulmonary vascular system is distributed similarly to the branching of a large tree, albeit with different sizes and quantities compared to other organs’ blood vessels.
This is what is said, however, the visual effect of the contrast agent post-injection is quite distinct for doctors. On the display screen, the left and right thick pipes resembling large plumbing heads erge with tufts like a feather duster’s black line cluster representing the pulmonary artery system. The blood vessel distribution map from heart coronary angiography does not display such a frightening density.
This is how normal vascular imaging looks, but once a blockage occurs, if it’s a unilateral pulmonary trunk blockage, it’s not surprising; it could be a spectacular scene with one side of the feather duster entirely dulled. Enough to make dical students feel instructed upon witnessing it. This might not be quite like coronary angiography, where the vascular absence in coronary angiography from the previous surgery resembled segnts of blank tubing.
User Comments
0 comments from readers