"It's for ivus." Shen Youhuan hit his palm with his fist, and finally remembered that there was such a specialized examination, and said, "I thought she was going to do an esophageal ultrasound, and I thought, wasn't this done? Could it be done during the operation?
Do?"
Ivus is intravascular ultrasound, which can also be used to examine the intravascular conditions of coronary arteries. The difference from coronary angiography is that it does not require the use of contrast agent for fluoroscopy to reveal the thickness of blood vessels, but directly sends a miniature ultrasound probe into the blood vessels.
To detect the internal conditions of blood vessels. For further examination, there is future OCT, which uses infrared rays to measure blood vessels, which is more accurate than ivus.
Why are the latter two technologies not commonly used in clinical practice? There is only one main reason: they are expensive.
Relatively cheap coronary angiography can already achieve very good results, so why use these two technologies? Besides, after these two technologies have been detected, stent placement still requires the use of angiography technology. This means that the cost has doubled, and the efficacy has increased exponentially.
But the difference is not big. Doctors know which one to choose for the sake of ordinary people.
These two technologies are not clinically unnecessary. As long as any technological invention can survive, it must have irreplaceable usability.
Like oct, ivus 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 a coronary angiogram reveals that the stenosis of the blood vessel is less than the limit required for stent placement. Legally, if a doctor puts a stent on a patient, it is excessive medical treatment and produces other sequelae, and he will be sued. The patient's symptoms are not relieved.
It also brings other high risks. Doctors can only seek other evidence. At this time, ivus may play a key role. For stenosis that cannot be seen on coronary angiography, ivus can.
The reason is that the results of coronary angiography are only the lumen size of the coronary arteries and cannot detect the blood vessel wall, leading to an underestimation of the severity of vascular stenosis.
For example, most patients with coronary heart disease have stenoses caused by atherosclerotic plaques. Only ivus can detect early sclerotic plaques on the blood vessel wall and tell doctors the severity of the disease, which can prompt the need for stent placement one step earlier than coronary angiography.
For the same reason, for some young patients who have symptoms of coronary heart disease and angiography shows severe stenosis, doctors know that they may not have the age basis for atherosclerosis. At this time, if they do not put a stent in the patient, it is considered medical negligence and they may be sued for negligence.
Using ivus to measure the condition of the blood vessel wall can help doctors find more concrete evidence for judgment. When the blood vessel wall lesions are not serious, it is not too late to remove the thrombus first, and then decide whether to insert a stent after a certain period of time. It is best not to over-treat.
Overtreatment.
In the case of patient Xiao Shugang, coronary angiography may not be able to detect stenosis or which segment is stenotic, and it does not necessarily require a stent. What needs to be checked more is the condition of the blood vessel wall to see if there is any damage after the car accident.
trace.
"The problem I gave him for this examination can only be seen from the inside, not from the outside." Shen Youhuan conducted academic exchanges through his spokespersons, classmates Pan and Xie.
"Yingying said that the inside and outside are connected, and we can determine the area where the surgical operation is to be performed." Pan Shihua said.
"Does she mean 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 solved first," Pan Shihua said.
