Chapter 2010 【2010】High Risk
Yes, the catheter for interventional surgery can only be placed at the proximal end of the ophthalmic artery for injection or stenting. If these places are blocked, needless to say, there is a chance to put catheters and stents here, and the effect of thrombolysis and thrombolysis is better.
The catheter and stent are limited by the diameter of the blood vessel and cannot be sent to the terminal blood supply vessel of the retina. The only thing left is whether the remaining thrombolytic drug can pass through the ophthalmic artery to accurately reach the blocked position of the retinal artery and dissolve it, maybe it can. It's just that if thrombolytic drugs are feasible, why bother to do this interventional operation, it's the same as directly injecting the systemic vein.
Dr. Hu's attending ophthalmologist, as a bigwig in the industry, knows the basics of these operations and will not deceive colleagues like Dr. Hu. After a preliminary examination, it was judged that the possibility of an embolus like Dr. Hu's at the end was very high, and it was afraid that the thrombectomy and stent would not be successful.
Any surgery has risks.
People abroad have done research earlier, and there is no difference in the therapeutic effect of intravenous thrombolysis and interventional local thrombolysis. This is number one. The second is that the risk of interventional surgery in ophthalmology is very high, which is tens of percent higher than the adverse incidence rate of intravenous thrombolysis.
The interventional surgery in ophthalmology is not performed by ophthalmologists. Ophthalmologists are on-site to assist, and internal medicine interventional doctors are required to do it. It can be seen from the above-mentioned incidence of surgical adverse events that the technical level of interventional surgeons is very high.
Think about it, domestic interventional surgery is catching up with foreign countries so far, and the training of interventional surgery doctors can be said to have not reached foreign standards, and there are very few genuine ophthalmic interventional skills. Other foreign experts do this, but there are very few experts and doctors who you want to find such a guarantee in China. What's more, it is extremely rare for Dr. Hu to have binocular attacks instead of monocular ones, and the risk of interventional surgery is higher.
Finally, the effect of Dr. Hu's previous intravenous thrombolytic therapy proved that it was correct not to perform interventional surgery. Because the thrombus in Dr. Hu's central retinal artery cannot be completely dissolved by thrombolytic drugs. It means that you have a high risk of local thrombolysis in interventional surgery and it is also useless.
After listening to the doctor's words, Mr. Liu drooped his head, indicating that the information he obtained for his wife was invalid.
I am not an expert, so the fragmented information from hearsay must be biased, which is normal.
Maybe his wife, Dr. Hu, almost gave up because she knew this early on.
Mr. Liu looked sad, and asked the doctor earnestly: "Last night, many doctors suggested that I come to see you, Doctor Cao. Is there nothing you can do about my wife's illness? In fact, what their doctors said last night , I don’t understand very well. Is there a way to find out the nerves for ophthalmology diseases?”
"I just told you about the part of the ophthalmology treatment. Your wife took a thrombolytic drug within a few hours, knocked out some of the emboli, and bought yourself precious delay time, so that the doctor can think of other ways to treat you. Wife’s illness. At first glance, the rest of your wife’s embolus should be calcification or cholesterol, so it cannot be dissolved. If it cannot be dissolved, we can only find a way to get the embolus out.” Cao Yong Said, "Diseases like your wife often occur together with stroke, which has shown that the two are closely related. Dr. Hu's disease belongs to ophthalmology. extraneural. The ophthalmic artery itself is a blood vessel that enters the brain."