Not only during puncture, if you are afraid of making mistakes, try to send the guide wire under fluoroscopy without inserting it blindly. If the guide wire is sent to the wrong place at this time, it can only be a special situation.
Is there something blocked in the blood vessel? Arterial occlusion usually occurs in the lower limbs and is unlikely to occur in the upper limbs. The doctor will recommend heparin and double-antibodies are required for interventional surgery. The doctor is more afraid of massive bleeding during the delivery of the guide wire. 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 alleviate such symptoms.
The probability of the above two happening is low. Jin Tianyu thinks so. The reason can only go back to the possibility of the guide wire entering the wrong branch. Whether the guide wire goes into the wrong branch or not cannot be fully seen from a flat perspective.
"How high was the resistance when you sent it in? Is it very big?" Jin Tianyu asked Dr. Fang again to confirm whether the guide wire had entered the wrong branch just now.
Everyone in the control room is listening to the answer together.
When the branch is penetrated, the resistance will increase. The diameter of the branch is smaller than that of the main trunk, and a skilled doctor can feel this subtle feeling. Therefore, 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 definitely not dare to force it."
Slowly, without encountering any big resistance along the way, it means that the route is correct. How could it suddenly go wrong? Dr. Fang couldn’t understand. The guide wire should have slid in along the large channel. Is the route easy to follow? The doctor said
The guide wire walked down the path on its own without being forced? And the fluoroscopic images he saw did not show that the guide wire went to the branch.
"Why don't you try it yourself." Dr. Fang couldn't figure it out, so he suggested to Jin Tianyu to try it himself to see if what he said was right.
Jin Tianyu made no move, obviously he wanted to weigh the pros and cons.
Dr. Fang had 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 only increase the risk. He was lucky enough to have the guide wire withdrawn. If it gets stuck again,
You may not be able to successfully withdraw the guide wire like you did just now.
"Hanging." Li Chengyuan looked anxious at the people in the operating room who were not moving, and said to Fu Xinheng, "It's hard to say whether they have sent it to the brachial artery. It is more difficult to get to the axillary artery, subclavian artery, and aortic arch later."
The guidewire goes from the radial artery to the cardiac artery, passes through the brachial artery, axillary artery, subclavian artery, and then the aortic arch and finally reaches the bottom of the aortic sinus. At this time, a contrast agent is created to identify the blocked coronary artery segment, and a stent is placed if necessary.
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 it will send out other blood vessels on its way, such as the deep brachial artery, the superior ulnar accessory artery, the inferior ulnar accessory artery, etc.
The human cardiovascular system itself is an extremely complex and huge project, and blood vessels are an important part of the cardiovascular system. They are distributed throughout the human body in criss-cross directions, and each person's blood vessel map may be different.
When doctors learn medical knowledge, they can only learn about the parts of the human body that are basically the same. Minor differences can only be analyzed and controlled by clinicians based on individual cases. The vascular part of this case seems to be extremely difficult for doctors to figure out.
Take control.
The time of emergency patients is their life. The doctor cannot think slowly and slowly, he must make a decision or make a decision as soon as possible.
