Chapter 1365 【1365】Special Place for Surgery
"You're right." As the squad leader, Yue Wentong announced on the spot that classmate Pan's speculation about the patient's basic condition was correct, and he continued to tell the patient's self-reported medical history. Interventional surgery. It seemed that the situation was not serious a few months ago. I didn’t go to the emergency department. I just went to the outpatient clinic because my chest was uncomfortable. After angiography, I found that the left anterior descending coronary artery was stenotic. It was more serious, so a stent was placed after balloon dilatation."
It's her hometown. Xie Wanying thought.
"As for why it's so narrow?" Yue Wentong glanced at Feng again when he said this.
Does this question need to be asked?
In-stent restenosis is all too common. Besides, did he just say that the patient was sent to the emergency department because of in-stent restenosis?
Feng Yicong blinked and looked at the ceiling, hating himself for speaking without thinking. The class monitor is the top student in the class, second only to Yingying, the female top student.
How could he suspect in-stent restenosis before the patient underwent coronary angiography. Maybe another artery is clogged, or something else.
Pan Shihua swallowed his food, and said something fair for Feng, saying: "I can be sent to the emergency department in a few months, and the other blood vessels that have just undergone angiography a few months ago are fine for the time being, so the possibility of another accident in the stent should be relatively high." Tall.—Yingying, what do you think?"
When a classmate asked her opinion, Xie Wanying recalled that in this era before the advent of drug stents, bare stents were too easy to restenosis, which became a major obstacle to stent surgery. In fact, the direction of the two students' questions is correct. It's just that the squad leader is a very cautious person, and he won't say that he is suspicious before the results of the angiography test come out. The squad leader didn't say anything. It may be that patients with in-stent restenosis come to the emergency department very often, which means that the reason is unlikely to be that this patient needs to come down specially for the special place of this patient.
"The squad leader didn't finish talking." Xie Wanying said.
Being pointed out by her that he hadn't finished speaking, Yue Wentong was stunned for a moment, his eyes looked at her meaningfully. The monitor and the two students seem to be a bit predictable. The difference is that the logic of classmate Pan's speculation is at a superficial level, and the speculation logic of this female academic bully in their class is at a deep level, with brain secrets that others don't know.
"The teachers decided to puncture the radial artery for him." Yue Wentong said the main point.
"Don't go through the femoral artery, but go through the radial artery, why?" asked Feng Yicong, not afraid of being educated again by the monitor.
There are generally three surgical approaches for PCI, the femoral artery, the radial artery, and the brachial artery.
Among the three arteries, although the femoral artery is the farthest from the heart, it is the thickest and the easiest to puncture and insert a guide wire. The radial and brachial arteries are closer to the heart, but the diameter of the blood vessels is small, and there are several thresholds to pass in the path to the coronary arteries of the heart. The road is not as smooth as the femoral artery, so it is not easy to succeed.
Clinicians basically choose the femoral artery as the first choice without special circumstances. The selection of the radial artery must be due to the patient's own special circumstances that trigger contraindications to the femoral artery approach.
"The patient has arteriosclerotic obliterans? Is he taking anticoagulants?" Pan Shihua cited possible reasons.
Pan's grades are also very good in the class, otherwise he would not have been approved to enter the clinical practice in advance.