Abstract:Objective To compare the clinical application value of intravenous thrombolysis via dorsalis pedis vein and large lumen catheter combined with small dose urokinase in the treatment of middle and high risk pulmonary embolism. Methods A total of 60 patients who were diagnosed as acute moderate and high-risk pulmonary embolism according to their clinical manifestations, pulmonary CTA and DSA angiography from January 2015 to December 2019 were selected and divided into control group and study group (n=30, each).The patients in the control group were treated with anticoagulation and thrombolysis through dorsal vein of foot.On the basis of anticoagulation, the study group was treated with large lumen catheter and small dose of urokinase.The recovery time of pulmonary artery bleeding, the time of pulmonary artery blood saturation and the time of oxygen saturation (>95%) recovery in the two groups. Results The time of pulmonary artery thrombus clearance, oxygen saturation recovery time, clinical symptoms remission time and hospitalization time in the study group were less than those in the control group (P<0.05).The incidence of bleeding in the study group was slightly higher than that in the control group without significant difference (10.00% vs 6.67%,χ²=0.22, P=0.64). Conclusion On the basis of anticoagulation, large lumen catheter thrombectomy combined with low-dose urokinase thrombolysis in the treatment of acute middle and high-risk pulmonary embolism can let patients through the dangerous period in a short time without serious complications.It is a minimally invasive, safe and efficient method.