Is it good to place a filter for pulmonary embolism or not?

Written by Yuan Qing
Pulmonology
Updated on September 03, 2024
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Whether it is good or not to place a filter for pulmonary embolism mainly depends on the cause of the pulmonary embolism and whether there are indications for placing a filter.

Generally speaking, if pulmonary embolism is caused by the formation of blood clots in the lower limbs or the inferior vena cava, placing a filter can generally be beneficial. However, not all cases of lower limb venous thrombosis require a filter. Filters are usually only used for deep or large vein thromboses that are not suitable for thrombectomy or thrombolysis treatments. If a filter is placed under other conditions, it is very likely that thrombosis will re-form on the surface of the filter, potentially leading to some recurrent pulmonary embolisms or iatrogenic pulmonary embolisms. Therefore, the decision to place a filter is complex and requires a doctor to weigh the pros and cons before deciding whether or not to proceed.

Other Voices

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What should I do if I have pulmonary embolism and asthma?

Pulmonary embolism is a very common type of disease clinically, and its triggering factors are numerous and complex. For such patients, the main triggering factors are usually the detachment of thrombi from the pelvic deep veins and the lower limb deep veins, leading to pulmonary artery embolism. Therefore, the clinical symptoms that appear in these patients are mainly difficulty breathing, chest tightness, chest pain, and some patients may experience coughing, coughing up blood, shortness of breath, and even wheezing. Thus, for such patients, it is first necessary to clarify the cause of the disease, and then provide the patient with oxygen, thrombolysis, anticoagulation, and other symptomatic treatments. Usually, after effective symptomatic treatment, when the embolism location is effectively controlled, the symptoms of wheezing and air blockage that the patient experiences will also be significantly improved.

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Can a pulmonary embolism be detected by an X-ray?

Pulmonary embolism cannot be detected by X-ray. Although in rare cases, some signs might appear on an X-ray, such as localized sparse lung markings, these signs are typically not characteristic. For conditions like pulmonary embolism, color Doppler ultrasound can be used to assist in diagnosis. If the ultrasound suggests deep vein thrombosis in the legs along with pulmonary hypertension, it indicates a high possibility of pulmonary embolism. Additionally, testing for D-dimer and blood gas analysis can also help in diagnosing pulmonary embolism. CT pulmonary angiography can also be used to diagnose the condition. CT and pulmonary angiography have a high diagnostic value for pulmonary embolism, and most cases can be definitively diagnosed through these tests.

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Why does pulmonary embolism cause cardiac arrest?

The mechanisms causing cardiac arrest due to acute pulmonary embolism mainly encompass several aspects. One is a large-scale acute extensive pulmonary embolism, which prevents the blood from being ejected from the right heart, potentially leading to acute right heart failure. At this time, the entire body's blood circulation will encounter issues. Another scenario is that following the pulmonary embolism, it causes severe hypoxia. This hypoxia can lead to oxygen deficiency in all organs of the body, including the heart. The coronary arteries that supply nutrients to the heart can also become ischemic. Both of these factors can cause the heartbeat to lead to sudden cardiac arrest. These are the primary mechanisms that can cause a sudden stop in the heartbeat.

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Can acute pulmonary embolism be cured by anticoagulation?

Anticoagulation has a partial curative effect on acute pulmonary embolism. Based on the area of the embolism and the patient's vital signs, it is classified into mild, moderate, and severe pulmonary embolism. If it is a mild to moderate pulmonary embolism, anticoagulation can completely cure it, because anticoagulation can help the body's fibrinolytic system remove the blood clots that have already formed, and it can also prevent new clots from forming. However, in cases of severe pulmonary embolism, especially when the patient presents unstable vital signs and is in life-threatening condition, it is not advisable to rely solely on anticoagulant therapy. This is because the effect of anticoagulant treatment is relatively slow, and it requires a certain amount of time for the body's immune and fibrinolytic systems to clear the embolism. Therefore, at such times, thrombolytic treatment is recommended. Of course, this requires an experienced physician to assess the patient's vital signs and overall condition.

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Pulmonary Embolism Interventional Treatment Methods

Interventional treatment for pulmonary embolism is mainly used for large pulmonary embolisms in the main trunk or major branches of the pulmonary artery. It is applicable in the following scenarios: contraindications to thrombolysis and anticoagulation therapy, inefficacy after thrombolysis or aggressive medical treatment, or lack of surgical conditions. Interventional therapy for pulmonary embolism can involve removing the embolus or breaking it into fragments, allowing it to move to the distal pulmonary arteries, thereby opening the central pulmonary arteries, rapidly reducing pulmonary artery resistance, significantly increasing total pulmonary blood flow, improving cardiopulmonary hemodynamics, and right ventricular function. The treatment involves catheter fragmentation and suction of large clots in the pulmonary artery or performing balloon angioplasty, and it also enables local administration of small-dose thrombolysis. These are the primary methods of interventional treatment for pulmonary embolism.