Chapter 1384 [1384] Hanging

Not only during the puncture, if you are afraid of mistakes, try to send the guide wire under fluoroscopy without blindly inserting it. At this time, the guide wire was sent to the wrong place again. It can only be a special case.

Is there something blocked in the blood vessel? Arterial occlusion generally occurs in the lower extremities and is less likely to occur in the upper extremities. Doctors will recommend heparin, and double antibodies are required for interventional surgery. Doctors are even more afraid of bleeding during guide wire delivery. If the patient is nervous, vasospasm can also cause signs of guidewire jamming. For this reason, doctors routinely recommend verapamil and nitroglycerin, which can slightly relieve such symptoms.

The probability of the above two occurrences is low. Jin Tianyu thinks so. The reason can only go back to the possibility of the wire being strayed into the branch. Whether the guide wire is going wrong or not, the branch light may not be able to fully see the whole picture from the perspective of the plane.

"When you sent it in, how strong was the resistance? Is it very big?" Jin Tianyu asked Dr. Fang again, to make sure that the guide wire really went into the branch by mistake just now.

Everyone in the control room listened to the answer together.

Penetrating the branch, the resistance will increase. The diameter of the branches is smaller than that of the main trunk, and experienced doctors can feel this subtle touch. So Dr. Fang's accurate answer is very important.

Dr. Fang answered with difficulty while recalling: "I didn't feel much resistance before. If there was, I would not dare to force it."

Send it slowly, without encountering major resistance along the way, it means that the route you are taking is correct. How could it be wrong all of a sudden? Doctor Fang couldn't figure it out. The guide wire should have slid in along the large channel, so it was easy to go. Did the guide wire go to the path by itself without the doctor sending it by force? And he looked at the fluoroscopy screen and did not show that the guide wire went to the branch.

"Why don't you try it yourself." Dr. Fang couldn't figure out whether he could explain it or not, so he suggested to Jin Tianyu to try it himself to see if what he said was right.

Jin Tianyu didn't move, obviously he had to weigh the pros and cons.

Dr. Fang tried to get stuck in this place before, if he wants to try again, he must first find out the reason, otherwise it will be useless and will only increase the risk. I was lucky enough to pull out the guide wire just now. If it gets stuck again, I may not be able to successfully withdraw the guide wire as lucky as before.

"Hanging." Li Chengyuan looked anxiously at the people in the operating room, and said to Fu Xinheng, "Whether they have been sent to the brachial artery is hard to say. It will be more difficult to get to the axillary artery, subclavian artery, and aortic arch."

From the radial artery to the cardiac artery, the guide wire needs to pass through the brachial artery, axillary artery, subclavian artery, then to the aortic arch and finally to the aortic sinus floor. At this time, a contrast agent is created to determine the blocked coronary artery segment, and a stent is placed if necessary.

Among them, the lower segment of the brachial artery is formed by the confluence of the ulnar artery and the radial artery. At the same time, it is an arterial trunk, which means that other blood vessels such as the deep brachial artery, superior ulnar artery, and inferior ulnar artery will emerge from it.

The human cardiovascular system itself is an extremely complex project, and blood vessels are an important part of the cardiovascular system. It is distributed in the whole body of the human body in a criss-cross direction, and each person's blood vessel map may be different.

Doctors learning medical knowledge can only learn the similarities in human body structure, and the minor differences can only be analyzed and controlled by clinicians based on individual cases. Now the vascular part of this case seems to be extremely difficult for the "abnormal" part, and it is difficult for doctors to control it all at once.

The time of an emergency patient is life, and it is impossible for a doctor to ponder slowly, and must settle or make a decision as soon as possible.