"You're right." As a squad leader, Yue Wentong was feeling happy when he should feel comfortable. He announced on the spot that Pan's guess about the patient's basic condition was correct, and continued to tell the patient's self-reported medical history, "The patient was previously treated at the Department of Cardiovascular Medicine, Zhongshan First Affiliated Hospital.
Interventional surgery. A few months ago, the situation did not seem to be serious. I did not go to the emergency department. I just felt uncomfortable in my chest and went to the outpatient clinic. Later, angiography showed that the left anterior descending coronary artery was stenotic. The degree of stenosis was according to what the doctor said at the time as reported by the patient.
It was quite serious, so a stent was placed after balloon dilation."
This is her hometown, Xie Wanying thought.
"As for why it's so narrow?" When Yue Wentong said this, he glanced at Student Feng again.
Does this question need to be asked?
In-stent restenosis is too common. Besides, did he just say that the patient was sent to the emergency room due to in-stent restenosis?
Feng Yicong blinked and stared at the ceiling, hating himself for speaking carelessly. The monitor is the top student in the class, second only to the female top student Yingying.
How could he suspect that in-stent restenosis was the cause before the patient underwent coronary angiography? It might be that other arteries were blocked, or it might be some other reason.
Pan Shihua swallowed his food and said something fair for Mr. Feng, saying: "We can be sent to the emergency room in a few months, and we just had angiography a few months ago and other blood vessels are fine for now. The possibility of something happening again in the stent should be relatively high."
High.——Yingying, what do you think?"
When asked by a classmate for her opinion, Xie Wanying recalled that in this era, drug stents had not yet come out, and bare stents were too easy to re-narrow, thus becoming a major obstacle to stent surgery. In fact, the two classmates' questions were in the right direction. But the monitor
He is a very cautious person. He would not make any assumptions before the results of the angiography examination come out. There is something he did not say in class. It is very common for patients to come to the emergency department due to in-stent restenosis, which means that this is unlikely to be the reason.
The patient's special needs require Brother Jin to come here specially.
"The monitor didn't finish speaking." Xie Wanying said.
When she pointed out that he had not finished speaking, Yue Wentong was stunned for a moment, and his eyes looked at her with a hint of meaning. The two classmates in the class seemed to be a bit knowledgeable about things. The difference was the logic of Pan's speculation.
It is at a shallow level, but the inference logic of the female top student in their class is at a deep level, and she has brain secrets that others don't know.
"The teachers decided to perform radial artery puncture on him." Yue Wentong said the key point.
"Instead of passing through the femoral artery, we have to go through the radial artery. Why?" Feng Yicong asked, not afraid of being lectured again by the squad leader.
The surgical approaches for PCI are generally three: the femoral artery, the radial artery, and the brachial artery.
Among the three arteries, the femoral artery is the farthest from the heart, but it is the thickest and easiest to puncture and insert a guidewire. The radial artery and brachial artery are closer to the heart, but the diameter of the blood vessels is small, and they go to the coronary arteries of the heart.
There are several thresholds to pass on the path. The road is not as smooth as the femoral artery, so it is not easy to succeed.
Clinicians will basically choose the femoral artery as the surgical route unless there are special circumstances. Choosing the radial artery must be because the patient has special circumstances that trigger contraindications for the femoral artery approach.
"The patient has arteriosclerosis 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 internship in advance.