The Three-pronged Approach Solves Thrombosis Problems Easily*

  Eighty percent of cancer patients die from complications

  According to statistics, about 80% -90% of patients have died of tumor complications, rather than from tumor itself. Tumor complications can produce different degree of effect on patient's life, and serious complications are major causes of cancer patients’ death. Many cancer patients not only need to fight with cancer, but also need to tolerate the suffering brought by complications.

  38 -year-old Estrella, a cervical cancer patient from the Philippines, had suffered from left lower extremity deep vein thrombosis after six months of chemotherapy and radiotherapy. This was a complication due to vena cava oppression caused by tumor of cervical cancer. The oppression made vessels become narrow, so that blood of lower limb could not smoothly return to heart, forming severe blood retention in the lower extremities and resulting in limb swelling and pain.

  Abnormal swelling and pain of left leg made her unable to walk; even her right leg was also affected. This kind of pain made Estrella frown all day, but what was even more worrying was if it could not treated timely, it would likely lead to amputation or death.

  Traditional therapy was difficult to ensure security

  Director Wang Ronghua of Modern Cancer Hospital Guangzhou introduced that, thrombolytic therapy was the main method for treating deep venous thrombosis. The thrombolytic drugs can be injected through the peripheral peripheral vein, resulting in thrombus deciduousness and facilitating blood circulation. But deciduous thrombus can flow into the lungs and form pulmonary artery embolism. Pulmonary artery embolism will accelerate the death of patients; therefore, if there is only implementation of thrombolysis, it is difficult to ensure safety of the treatment.

  Being brave to make innovation to solve problem with new technologies

  Director Wang Ronghua presented that set a filter in the vena cava, and fine mesh of the filter can prevent blood clots from flowing back into the lungs. This is of important significance in preventing the formation of pulmonary embolism in clinical. This method is often used during thrombolysis surgery of deep venous thrombosis of lower limbs. However, blood vessels of Estrella have been suppressed so severe that filter’s screen could not be opened.

  When all the doctors were at loss how to do this surgery, Director Zhen Yanli and Director Wang Ronghua of Modern Cancer Hospital Guangzhou surgical intervention, owning many years of clinical interventional surgery experience, combined three surgeries in a thoughtful and innovative way to solve the medical problem successfully.

  They implemented three steps in the single operation: ① first conducted bracket transplantation surgery. The bracket, transplanted in narrow blood vessels, could prop the vessels open.② Implanted filter into the bracket, the filter in the propped blood vessels can smoothly open to prevent shedding of thrombus from flowing back to the lungs. ③ Implanted micro small intravascular catheter of 0.038inch in fine blood vessels, and injected thrombolytic drugs through the micro-catheter to perform thrombolytic surgery. It is understood that this three-pronged surgical approach is very rare in China, because the surgery of implanting filter in the bracket is very difficult and needs superb operating level of doctors.

cervical cancer, lower limb vein thrombosis, Modern Cancer Hospital Guangzhou

Radiography of bracket after being implanted

cervical cancer, lower limb vein thrombosis, Modern Cancer Hospital Guangzhou

Radiography after filter implantation

cervical cancer, lower limb vein thrombosis, Modern Cancer Hospital Guangzhou

Radiography after thrombolysis

  Up to four hours later, the surgery has achieved very good results. By DSA angiography, it showed that the implanted filter expanded in good location; the right external iliac vein that had no blood flow before, can be seen a lot of collateral vessel formation; significantly enlarged bilateral ascending lumbar vein has regained normal reverse flow; left femoral vein has changed from the "thin" vessel into a apparent one with unobstructed flow. During the surgery, the patient had no uncomfortable symptoms but normal vital signs. Nowadays, leg swelling of Estrella has gradually reduced with the pain having already disappeared, and the long-lost smile has finally showed in her face. Her smile seems to thank all the efforts made by Modern Cancer Hospital Guangzhou for all the doctors here have done their best in searching for practical measures to alleviate patients’ pain.

cervical cancer, lower limb vein thrombosis, Modern Cancer Hospital Guangzhou

Leg swelling has obviously reduced

*Surgery, in addition to the appropriate chemotherapy and radiotherapy, are effective in treating early cancer, but certain patients in late stage of cancer may not be tolerate surgery well as they can be relatively weak. A combination of carefully planned minimally invasive therapy, chemotherapy or radiotherapy can effectively reduce the side effects and discomfort of treatment and may help patient get better efficacy.

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