New Technologies in Interventional Medicine

  Recently, the interventional department of our hospital carried out the first case of pulmonary artery thrombolysis + vena cava filter placement + lower limb vein thrombolysis in Wuhu city and even in southern Anhui province. Pulmonary embolism is a common clinical disease, and its incidence is second only to coronary heart disease and hypertension among cardiovascular diseases, and its mortality rate is second only to tumor and myocardial infarction, and the mortality rate of untreated pulmonary embolism is as high as 20-30%. Due to the lack of awareness and vigilance of the disease, and the lack of specificity of its clinical manifestations, there exists high clinical incidence, high misdiagnosis and high mortality rate. While deep vein thrombosis of the lower extremities is most likely to be complicated by pulmonary embolism, thrombosis appearing in the N and femoral veins and inferior vena cava may complicate pulmonary embolism in about half of the patients.  The patient, female, 53 years old, was admitted to the hospital with panic, chest tightness, weakness with syncope for 5 days. The patient had lower extremity deep vein thrombosis for more than 10 years in the past. After admission, pulmonary hypertension, pulmonary embolism, hypertension and ischemic encephalopathy were considered after relevant examinations. Chest CTA showed embolus formation in the right pulmonary artery trunk and the beginning of the left upper and lower lobe pulmonary arteries, and right pleural effusion. The patient was in critical condition, unable to get out of bed, and had to lie down while on oxygen. After the hospital-wide consultation, interventional treatment was recommended and transferred to our department. After full communication with the patient’s family, interventional treatment was started at 20:30 that night. First, deep venography was performed on both lower extremities, which showed occlusion between the left N vein and femoral vein, with visible thrombosis, and the opening of collateral circulation and patency of the left deep vein. Then, Seldinger technique was used to puncture the femoral vein, a guide sheath was placed, and a pigtail catheter was fed into the common iliac vein to perform inferior vena cava angiography in a subset of the common iliac vein, which showed patency of the vena cava and no obvious thrombosis. The right pulmonary texture was significantly reduced, the filling defect of the right upper pulmonary artery was seen, and the filling defect of the left pulmonary artery branch was faintly seen. The operation was successfully completed at 23:10. After the operation, the patient continued to receive thrombolytic and anticoagulant treatment, and was able to get out of bed the next day and was discharged one week after the operation.  The Department of Interventional Medicine was established in 1998 and is a key department of the hospital. There are one chief physician, two deputy chief physicians, four attending physicians and four people with master’s degree or above. It is the largest interventional department in the south of Anhui Province, and the level of projects carried out is among the highest in Anhui Province. The department is divided into two specialized treatment groups, specializing in the comprehensive treatment of various solid tumors such as interventional therapy, combined arteriovenous therapy and molecular targeted therapy. We have deep attainments in interventional treatment of lumbar disc herniation, uterine fibroids, various vascular diseases, cysts in liver, kidney, ovary and other parts of the body, as well as puncture biopsy of unexplained occupancy in various parts of the body. He has won several provincial and municipal awards for scientific and technological progress and achievements, and seven national utility model patents. We are the first to carry out many new technologies such as intestinal stent placement, angioplasty and stent placement, abdominal nerve block for advanced cancer pain, tumor radiofrequency ablation and particle implantation, which fill the gaps in the hospital and the city. All medical and nursing staffs of our department will do their best to provide quality services for patients.