Digital imaging to erase the background and thrombolysis of blood vessels in the extremities
1. What is local catheter fibrinolysis?
1.1 Indications for the use of local catheter fibrinolysis
1.2 Contraindications for local catheter fibrinolysis
Chronic arterial - venous thrombosis of the extremities (> 3 weeks)
Allergy to iodinated contrast media
● Renal failure (grade IV) )
Severe and uncontrolled clotting disorder (Prothrombin >1.5, platelet count < 50 G/l)
2. Manpower, means of machinery, drugs and medical supplies
Doctor, anesthesiologist (if the patient cannot cooperate)
2.2 Vehicles and machines
● Dedicated electric pump.
Lead vest, apron, X-ray shielding
● Film, film printer, image storage system.
General anesthetic (if anesthesia is indicated)
Distilled water or Physiological saline
Water-soluble iodinated contrast agent
2.4 Medical supplies
Syringe for electric pumps
● Cotton, gauze, medical bandage
● Gloves, shirt, hat, medical mask
● Aseptic intervention kit: knife, scissors, tongs, 4 metal bowl, bean tray, tool tray
Contrast drug box and first aid kit
2.5 Special medical supplies
Size 4-5F angiography catheter.
The size 5-6F inlet opening kit.
Standard conductor 0.035inch.
● Y-wire set.
Thrombolysis catheter with multiple lateral holes and closed valve at the tip (Mcnamara catheter).
2.6 What do patients need to prepare before performing fiber lysis?
At the intervention room, the patient lies on his back, has a machine to monitor breathing, pulse, blood pressure, electrocardiogram, SpO2. Disinfect the skin, then cover with a sterile, perforated cloth. In case the patient is too excited, cannot lie still, it is necessary to give sedation or anesthetic.
3. Steps to conduct local fibrinolysis through catheters
● The patient lies supine on the table, placing an intravenous line.
● Local anesthesia is the commonly used form, which can be pre-anesthetic or anesthetic in cases where coordination is not possible.
Step 2: Insert the tube into the vascular lumen
● Depending on the location of the thrombus and the purpose of the intervention, it is possible to open the way into the lumen according to the position or the direction of the flow.
● Using a set of 21G micropuncture needles (micropuncture) poked into the vessel lumen under ultrasound guidance.
● Place the tube in the vessel.
Step 3: Angiography to assess the damage
● Conduct angiography of the lower extremities through the catheter.
Assess the entire limb vascular system above and below the lesion.
● Place the wire inside the thrombus so that the tip of the wire is outside the thrombus.
Step 5: Therapeutic intervention ● Insert the dedicated catheter with multiple lateral holes into the thrombus along the wire, so that all the lateral holes of the catheter are inside the thrombus.
● Using an electric syringe and wiring system, continuously infuse thrombolytic drugs through the Mcnamara catheter at the specified dose.
● Using an electric syringe and connecting wire, continuously infuse Heparin anticoagulant through a tube into the lumen (intravascular tube).
● Continuous transmission time 16-24h.
This technique may have some complications such as vasospasm, broken catheter, hematoma at the site of opening the way into the lumen.
Vinmec International General Hospital with a system of modern facilities, medical equipment and a team of experts and doctors with many years of experience in the examination and treatment of vascular diseases, patients completely You can rest assured that you will be examined and treated at the Hospital.
Dr. Nguyen Van Phan is an interventional radiologist and radiologist, with extensive experience in diagnosing and performing vascular interventions such as brain aneurysm implantation, brain stenting, and vascular malformations. cerebrovascular brain; embolization to treat hemoptysis; treatment of liver tumors, uterine fibroids, benign prostatic hypertrophy, stem cell transplantation for treatment of cirrhosis, congenital biliary atrophy, Type II diabetes... Non-vascular interventions such as high-frequency ablation frequency (RFA) treatment of liver tumors, benign thyroid tumors; aspiration and drainage of abscesses, drainage and stenting of biliary tract, urinary kidney; aspiration cytology and biopsies of breast, thyroid, lymph nodes, soft tissue, biopsies of liver tumors, lung tumors, bone tumors ...
To register for examination and treatment at Vinmec International General Hospital, Please make an appointment on the website to be served.
Để đặt lịch khám tại viện, Quý khách vui lòng bấm số HOTLINE hoặc đặt lịch trực tiếp TẠI ĐÂY. Tải và đặt lịch khám tự động trên ứng dụng MyVinmec để quản lý, theo dõi lịch và đặt hẹn mọi lúc mọi nơi ngay trên ứng dụng.