Chapter 1634 [1634] Technical Comparison
"It's for IVUS." Shen Youhuan smashed his fist into the palm of his hand, finally remembered that there was such a specialist examination, and said, "I thought she was going to do an esophageal ultrasound. Do?"
IVUS is intravascular ultrasound, which can also be used to check the intravascular situation of coronary arteries. The difference from coronary angiography is that it does not need to use a contrast agent for fluoroscopy to develop the thickness of blood vessels, but directly sends a micro-ultrasound probe into the blood vessel to detect the internal conditions of the blood vessel. Further inspections include future OCT, which uses infrared rays to measure blood vessels, which is more accurate than IVUS.
Why are the latter two techniques not commonly used clinically? The main reason is only one, expensive.
Relatively cheap coronary angiography can achieve good curative effect, why use these two techniques. Besides, after the detection of these two technologies, the placement of the stent still requires the use of imaging technology. It is equal to the doubled cost, but the curative effect is not much different. Doctors know which one to choose for the sake of ordinary people.
These two techniques are not clinically useless. As long as any technological invention can survive, it must have its irreplaceable usability.
IVUS, like OCT, is much more accurate than coronary angiography.
This high accuracy can be used in many difficult cases.
For example, a patient has typical clinical symptoms, and coronary angiography shows that the stenosis of the blood vessel is less than the limit value required for stenting. According to the law, if a doctor puts a stent on a patient, it is considered excessive medical treatment and produces other sequelae, and he will be accused. Patients with unrelieved symptoms also carry other high risks. Doctors can only seek other evidence. At this time, IVUS may play a key role, and IVUS can be used for stenosis that cannot be seen by coronary angiography.
The reason is that the result of coronary angiography is only the lumen size of the coronary artery, and the vessel wall cannot be detected, leading to an underestimation of the severity of vascular stenosis.
Most patients with coronary heart disease have stenosis formed by atherosclerotic plaques. Only IVUS can detect early vascular wall sclerotic plaques and tell doctors the severity of the lesions in this area, suggesting the need for stents one step earlier than coronary angiography.
The same reason. For some young patients, coronary heart disease symptoms and angiography suggest severe stenosis. Doctors know that they may not have the age basis of atherosclerosis. If they do not place stents at this time, it is medical negligence and they may also be accused. Using IVUS to measure the condition of the blood vessel wall can help doctors find more accurate evidence for judgment. When the vascular wall disease is not serious, the thrombus should be cleared first, and it is not too late to decide whether to place a stent after a certain period of time. It is better not to over-treat if possible.
For the patient Xiao Shugang, the stenosis may not be seen by coronary angiography or the stenosis may not necessarily be seen. What needs to be checked is the condition of the blood vessel wall to see if there are signs of damage after a car accident.
"The problem I have to do this inspection for him can only be seen from the inside, not the outside." Shen Youhuan conducted academic exchanges through the spokespersons Pan and Xie.
"Yingying said that the internal and external are connected, so she can determine the area where the surgical operation will be performed." Pan Shihua said.
"She means to solve the problem of the patient's limited surgical area first?" Shen Youhuan asked.
"She means that the blood supply area of the heart must be resolved first." Pan Shihua said.