Chapter 1652 【1652】lung

Thrombolysis or not, whether it is thrombectomy or other measures, all need to wait for the results of angiography before considering.

Pulmonary embolism generally occurs in the main trunk of the left and right pulmonary arteries and their lower branches. Distal persistent pulmonary embolism is rare. Due to the strong self-dissolving ability of the thrombus circulating at the end of the pulmonary artery, the small thrombus at the end can completely be autolyzed by human blood vessels, without excessive thrombolysis by doctors. The doctor only needs to open up the main artery.

With this idea as a guide, it is like performing coronary angiography on the root of the main blood vessel. The doctor wants the contrast agent to 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 enters the right ventricle, and then the venous blood is output from the right ventricle to the pulmonary artery, from the pulmonary artery to the left and right pulmonary arteries 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 The left ventricle pumps out to the whole body, this cycle is called pulmonary circulation.

Venous blood flows into the pulmonary arteries, not arterial blood, and arterial blood flows through the pulmonary veins. The venous flow of the systemic circulation is venous blood, and the arterial flow is arterial blood. This is the most misunderstood thing for laymen. Therefore, pulmonary artery thrombolysis dissolves venous thrombosis, and the femoral vein is pierced instead of the femoral artery. This is different from coronary angiography.

It is enough to illustrate the complexity and variety of interventional surgery.

The doctors in the control room watched the angiography results together with the surgeons in the operating room through the lead glass and witnessed the real-time progress of the operation.

After the contrast machine is started, a thin wire tube can be seen coming to the lower end of the lung. Similar to coronary angiography again, the doctor at the end of the catheter has to find a way to prevent the catheter from slipping out and wrap it around like a small hook. Today is not the practice of young doctors. 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 human anatomy.

Most people don't see the process clearly. Da da, the contrast agent has been injected into the blood vessel for imaging.

The principle is exactly the same as other interventional operations. Where the blood vessels are blocked, the contrast agent will not pass through, and the lack of contrast will appear as a blank, that is, no black and white. In the pulmonary artery, the left and right pulmonary artery thrombus blocks the lack of pulmonary artery visualization. It may be that the visualization of a unilateral pulmonary artery is all dim. The visual effect on the display screen is amazing, and it may be more shocking than coronary angiography.

First of all, we need to talk about the normal development of blood vessels, the pulmonary vascular system is the same as the blood vessels distributed in other human organs, just like the branches of a big tree, but the size and number are different.

That being said, the difference in visual effect to the doctor after the contrast agent is injected is very obvious. It can be seen on the display screen that the left and right two thick-diameter sewer pipe heads look like blood vessels, and the black thread clusters like feather dusters are the pulmonary artery system. The blood vessel distribution map produced by coronary angiography does not have such a terrible density.

Normal angiography is like this. Once blockage occurs, if it is blocked by active dryness of one side of the lung, it is not surprising. It can be a magnificent scene where one side of the feather duster is completely dimmed. It is enough to make medical students see and feel taught. This may not be quite like coronary angiography. The lack of blood vessels shown by coronary angiography is like the last operation, which is like a section of blank line.