It is not just during puncture. If you are afraid of mistakes, try to send the guide wire under fluoroscopy instead of blind insertion. If the guide wire is sent to the wrong place again, it can only be a special case.
Is there something blocking the blood vessels? Arterial occlusion usually occurs in the lower limbs and is unlikely to occur in the upper limbs. Doctors will recommend heparin, and interventional surgery requires dual antibiotics. Doctors are more afraid of heavy bleeding during the delivery of the guidewire. If the patient is nervous, blood vessels may also cause signs of guidewire jamming. Doctors routinely recommend verapamil and nitroglycerin to slightly relieve such symptoms.
The probability of the above two happening is low. Jin Tianyu thinks so. The reason can only be traced back to the possibility that the guide wire entered the wrong branch. Whether the guide wire has entered the wrong branch or not may not be fully seen from the plane perspective.
"How great was the resistance when you put it in? Was it very strong?" Jin Tianyu asked Dr. Fang again to confirm whether the guide wire had really gone into the wrong branch.
Everyone in the control room was listening to the answer together.
When the branches are inserted, the resistance will increase. The branches are smaller in diameter than the trunk, and experienced doctors can feel this subtle touch. Therefore, Dr. Fang's accurate answer is very important.
Doctor Fang recalled and answered with difficulty: "I didn't feel much resistance before. If there was, I would definitely not dare to force it."
He pushed it in slowly, and encountered no major resistance along the way, which meant that the route was correct. How could it suddenly go wrong? Doctor Fang couldn't figure it out. The guidewire should have slid in along the main channel, which was an easy route to take. How could the guidewire go to the small path on its own without the doctor forcing it in? And the fluoroscopic image he saw did not show that the guidewire went to the branch.
"Why don't you try it yourself." Doctor Fang couldn't figure it out and suggested to Jin Tianyu that he try it himself to see if what he said was right.
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Jin Tianyu didn't move, obviously weighing the pros and cons.
Doctor Fang had been stuck at this place before. If he wants to try again, he must first find out the cause. Otherwise, it will be useless and will only increase the risk. He was lucky to get the guide wire out just now. If it gets stuck again, he may not be able to successfully get the guide wire out like he was just now.
"It's uncertain." Li Chengyuan was anxious as he saw the people in the operating room not moving. He said to Fu Xinheng, "It's hard to say whether they have delivered it to the brachial artery. It's even more difficult to reach the axillary artery, subclavian artery, and aortic arch."
The guidewire goes from the radial artery to the cardiac artery, through the brachial artery, axillary artery, subclavian artery, aortic arch and finally to the aortic sinus. At this time, contrast agent is created to identify the blocked coronary artery segment, and stents are placed if necessary.
The lower segment of the brachial artery is formed by the confluence of the ulnar artery and the radial artery. It is also an arterial trunk, which means that other blood vessels, such as the deep brachial artery, the superior ulnar collateral artery, and the inferior ulnar collateral artery, will branch out from it.
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, crisscrossing and crisscrossing, and each person's blood vessel map may be different.
Doctors can only learn about the parts of the human body structure that are similar when learning medical knowledge. Minor differences can only be analyzed and controlled by clinical doctors based on individual cases. Now the blood vessels in this case seem to be extremely difficult, and it is difficult for doctors to control them all at once.
For emergency patients, time is life. Doctors cannot take their time to think about it. They must get it done or make a decision as quickly as possible.
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