New Milestone in Shanghai's Group-Based Medical Aid Program for Tibet: Shanghai General Hospital Specialist Performs Shigatse's First Dual-Technique Thrombectomy for Lower-Extremity Deep Vein Thrombosis

Source: https://mp.weixin.qq.com/s/-ljuNPbO9NqeglaLC-3Fng

Dr. Lu Ye, a member of Shanghai’s 12th cohort of professionals participating in the group-based medical aid program for Tibet and Director of General Surgery at Shigatse People’s Hospital, also serves in the Department of Vascular Surgery at Shanghai General Hospital (South). Working alongside local multidisciplinary teams, Dr. Lu successfully introduced two minimally invasive thrombectomy approaches tailored to patients with different clinical presentations. The achievement fills a longstanding gap in local venous thrombectomy services and represents another important outcome of Shanghai’s group-based medical aid to Tibet.

Extensive DVT involving the entire lower extremity is a potentially life-threatening vascular condition. It can develop rapidly, and thrombus dislodgement may lead to pulmonary embolism, a potentially fatal complication. Previously, owing to limitations in local medical resources and treatment capabilities, patients in the Shigatse region were largely managed with conventional anticoagulation therapy, leaving limited interventional options for severe cases. Some critically ill patients had to travel long distances to seek specialized treatment elsewhere.

The two patients treated in this procedure both had extensive DVT involving the entire lower extremity, but their clinical presentations and treatment needs differed considerably. One patient, in their seventies, had subacute mixed-age thrombi with a large clot burden and complex vascular anatomy. The other, a teacher in their forties, presented with acute, fresh thrombi in relatively small-caliber veins, making the preservation of vascular function and rapid postoperative recovery particularly important.

To address these differences, Dr. Lu’s team collaborated with specialists from the departments of cardiology, radiology, and ultrasound diagnostics at Shigatse People’s Hospital to establish a multidisciplinary team. After carefully evaluating each patient’s condition and optimizing the procedural approach, the team developed individualized minimally invasive thrombectomy strategies for both patients.

For the older patient with subacute DVT, the team adopted a technique combining inferior vena cava (IVC) filter protection with peripheral venous thrombectomy using a dedicated thrombectomy device. The IVC filter was deployed to intercept emboli and reduce the risk of pulmonary embolism. The thrombectomy device was then used to engage and remove the mixed-age thrombi. A substantial volume of thrombotic material was successfully extracted, restoring patency in the major femoral and iliac veins and overcoming the challenge of removing extensive, organized thrombi in the subacute phase.

For the younger patient with acute DVT, the team used a high-efficiency aspiration thrombectomy catheter system. The catheter was advanced directly to the site of thrombosis, where negative-pressure aspiration was used to remove the fresh thrombus through a minimally invasive approach. This enabled rapid clearance of the affected venous segments and restoration of blood flow. By minimizing procedural trauma and preserving native vascular function as much as possible, the approach was intended to support faster recovery and reduce the risk of post-thrombotic syndrome (PTS), a potentially debilitating long-term complication of DVT.

The successful introduction of these two complementary thrombectomy techniques marks a significant shift in the management of severe DVT in Shigatse, expanding local treatment options beyond anticoagulation alone to include minimally invasive clot removal for appropriately selected patients. The achievement has the potential to reduce the risk of serious complications and long-term sequelae while sparing local patients the physical strain, travel burden, and financial costs associated with referral to hospitals in other provinces. It also enables patients on the Tibetan Plateau to access more advanced vascular care closer to home.

Since beginning his aid assignment in Tibet, Dr. Lu has worked through Shanghai’s group-based medical aid mechanism to strengthen vascular surgery services at Shigatse People’s Hospital, focusing on both the introduction of advanced techniques and the development of local clinical capabilities. His work extends beyond performing procedures to include hands-on surgical training, case reviews and discussions, and regular technical training sessions.

Through this integrated approach, the initiative aims to move beyond short-term technical support toward sustainable capacity building. By training local professionals in vascular intervention and helping establish standardized pathways for the diagnosis and treatment of vascular diseases, the program is laying the groundwork for a stronger regional vascular care system.

Shanghai General Hospital will continue to leverage its specialist expertise and institutional resources to deepen its support for Shigatse People’s Hospital, strengthen local clinical capabilities, and expand access to high-quality medical services. Through sustained collaboration, the hospital aims to help safeguard the health and well-being of communities across the Tibetan Plateau.