"It's an IVUS." Shin Youhuan slammed his fist down on his palm, finally remembering that there was such a specialized examination. "I thought she was going to do an esophageal ultrasound. I thought, hasn't this been done? Could it be done during the operation?"
IVUS is intravascular ultrasound, which can also be used to examine the intravascular conditions of the coronary arteries. The difference from coronary angiography is that it does not require the use of contrast agents to perform fluoroscopy to visualize the thickness of the blood vessels, but directly inserts a miniature ultrasound probe into the blood vessels to detect the internal conditions of the blood vessels. Further examinations include the future OCT, which uses infrared rays to measure blood vessels and is more accurate than IVUS.
Why are the latter two technologies not often used in clinical practice? The main reason is that they are expensive.
The relatively cheap coronary angiography can already achieve good results, so why use these two technologies? Besides, after the two technologies are used for detection, stent placement still requires the use of angiography technology. This means that the cost has doubled, but the effect is not much different. Doctors know which one to choose for the sake of ordinary people.
These two technologies are not temporarily unused. As long as any technological invention survives, it must have its irreplaceable usability.
Like IVUS and OCT, its accuracy is much higher than that of coronary angiography.
This high accuracy can be used in many difficult cases.
For example, a patient has typical clinical symptoms, and coronary angiography finds that the degree of vascular stenosis is less than the threshold value required for stent placement. Legally, if a doctor places a stent on a patient, it is considered excessive medical treatment and produces other sequelae and he will be sued. The patient's symptoms are not relieved and other high risks are brought. The doctor can only seek other evidence, and IVUS may play a key role at this time. IVUS can be used to detect stenosis that cannot be seen by coronary angiography.
The reason is that the results of coronary angiography only show the size of the coronary artery lumen, and cannot detect the blood vessel wall, resulting in underestimation of the severity of vascular stenosis.
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Most patients with coronary heart disease suffer from stenosis caused by atherosclerotic plaques. Only IVUS can detect early atherosclerotic plaques on the blood vessel walls and tell doctors the severity of the lesions in this area, suggesting the need for stent placement one step earlier than coronary angiography.
The same goes for some young patients who have symptoms of coronary heart disease and whose angiography indicates severe stenosis. Doctors know that they may not have the age basis for atherosclerosis. If they do not place stents for these patients, it would be considered medical negligence and they may also be sued. Using IVUS to measure the condition of the blood vessel wall can help doctors find more accurate evidence for judgment. If the lesions on the blood vessel wall are not serious, it is not too late to clear the blood clot first and then decide whether to place a stent after a certain period of time. Overtreatment is best avoided if it is not necessary.
In the case of Xiao Shugang, coronary angiography may not be able to show stenosis or determine which part of the stenosis is present, and stent placement is not necessary. What is more important is to check the condition of the blood vessel wall to see if there are any signs of damage after the accident.
"The problem is that I can only examine him from the inside, not from the outside." Shen Youhuan conducted academic exchanges through his spokespersons, Pan and Xie.
"Yingying said that the inside and outside are connected, and we can determine the area where the surgical operation will be performed." Pan Shihua said.
"Does she mean that we need to solve the problem of the patient's limited surgical area first?" Shin Youhuan asked.
"What she meant was that we must first address the blood supply area of the heart," said Pan Shihua.
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