"You're right." As the squad leader, Yue Wentong was happy when he should be happy. He announced on the spot that Pan's guess about the patient's basic condition was correct, and he continued to tell the patient's self-reported medical history. "The patient had an interventional surgery in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Zhongshan. A few months ago, the condition didn't seem too serious, and he didn't go to the emergency room. He just went to the outpatient clinic for chest discomfort. Later, angiography revealed stenosis of the left anterior descending branch of the coronary artery. According to the patient's own account of what the doctor said at the time, the stenosis was quite serious, so a stent was placed after balloon dilatation."
It's her hometown, Xie Wanying thought.
"As for why it is narrower again?" Yue Wentong glanced at Feng while saying this.
Is this question necessary to ask?
In-stent restenosis is too common. Besides, did he just say that the patient was sent to the emergency room because of in-stent restenosis?
Feng Yicong blinked and looked at the ceiling, hating himself for speaking without thinking. The monitor was the top student in the class, second only to the top student Yingying.
How could he suspect the patient was suffering from restenosis in the stent before the patient had a coronary angiography? Maybe other arteries were blocked, or maybe there were other reasons.
Pan Shihua swallowed his food and spoke a fair word for Feng, saying, "He can be sent to the emergency room in a few months, and he just had angiography a few months ago. There is no problem with other blood vessels for the time being. The possibility of another problem in the stent should be relatively high. - Yingying, what do you think?"
When asked by her classmates for her opinion, Xie Wanying recalled that drug-eluting stents had not yet been invented, and bare stents were too prone to restenosis, which became a major obstacle to stent surgery. In fact, the two classmates were right in their questions. It was just that the monitor was a very cautious person and would not make random guesses before the results of the angiography came out. The monitor did not say something. It may be that patients with in-stent restenosis who come to the emergency room are very common, which means that this reason is unlikely to be that this patient has a special condition that requires Senior Brother Jin to come down specifically.
...
...
"The squad leader hasn't finished speaking." Xie Wanying said.
Yue Wentong was stunned when she pointed out that he hadn't finished speaking. He looked at her meaningfully. The two class monitors seemed to be able to predict the future. The difference was that Pan's logic of speculation was superficial, while the female student in their class had a deep logic of speculation, with brain secrets that others didn't know.
"The teachers decided to perform radial artery puncture on him." Yue Wentong pointed out the key point.
"Why go through the radial artery instead of the femoral artery?" Feng Yicong asked, not afraid of being lectured again by the squad leader.
There are three common surgical approaches for PCI: the femoral artery, radial artery, and 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 the brachial artery are closer to the heart, but the blood vessels are smaller in diameter, and there are several barriers to pass on the way to the coronary artery. The road is not as smooth as the femoral artery, so it is not easy to succeed.
Clinicians will generally choose the femoral artery as the surgical route unless there are special circumstances. If the radial artery is chosen, it must be because the patient has special circumstances that trigger contraindications to the femoral artery approach.
"Does the patient have arteriosclerosis obliterans? Is he taking anticoagulants?" Pan Shihua gave possible reasons.
Student Pan’s grades are also very good in the class, otherwise he would not have been able to enter clinical internship in the early batch.
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