The cardiologists raised their hands in surrender, feeling embarrassed to ask their neurosurgery colleagues on the spot. Lin Chenrong walked behind Xie and whispered, "Do you know what's going on now?"
"The first picture is a right-side aortic arch angiography, which is normal." Xie Wanying started communicating with Teacher Lin from the beginning, choosing to start with the cardiovascular angiography that Teacher Lin was most familiar with.
Before Lin Chenrong heard what she said, she had never remembered that extraneural angiography should start from the aortic arch, the blood vessels exiting the heart. She was a little stunned.
What’s even more frightening is that he, a cardiovascular specialist, didn’t think of this, but she, an intern, thought of it right away and was not confused at all.
It's right to ask classmate Xie, Lin Chenrong thought. Younger or less capable people may not be as quick-witted as her.
Deputy Director Lu on the opposite side turned his head, as if eavesdropping on their conversation. Interventional surgery is a new technology, which is not something that old doctors who are used to traditional surgery are good at. For an old doctor like Deputy Director Lu, it was indeed difficult to associate for a while.
"Please continue." Lin Chenrong said to Xie, standing next to her and listening attentively.
It is not surprising that neurointerventional angiography starts from the aortic arch. This is because the aortic arch is the starting point of the systemic arterial system, including the cerebral vascular artery network. Specifically, the aortic arch gives rise to the brachiocephalic trunk, the left common carotid artery, and the left subclavian artery. The brachiocephalic trunk gives rise to the right common carotid artery and the right subclavian artery. The left and right common carotid arteries give rise to the left and right internal carotid arteries, and the left and right subclavian arteries give rise to the left and right vertebral arteries.
Here is the key point: the left and right internal carotid arteries and the left and right vertebral arteries are the arterial trunks that branch off the cerebral blood vessels.
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Therefore, after checking the aortic arch, the next parts to be checked in the neurointerventional vascular examination are the left and right internal carotid arteries and the left and right vertebral arteries.
Just like checking the water network system, we must first find out whether there are any problems at the source, and then further check whether there are any problems with the various channels of the water network.
"The second step is to check the left and right internal carotid arteries. No abnormalities are found for the time being. There seems to be a little bit of narrowing in a section of the right vertebral artery." Xie Wanying continued to talk about the imaging results of the just-concluded surgery.
Has it been found out? Is there something wrong with the patient's blood vessels? The group of people standing behind were shocked. This meant that the surgeon in the operating room was operating too fast. If he was not careful, the bystanders who only watched and did nothing would not be able to keep up with the pace.
Xie described each scene without missing any details, and his fast-paced memory is amazing.
"Didn't the CT report have to be written before?" Lin Chenrong raised some doubts. He had not read the patient's medical records and was not clear about some issues.
"The stenosis of this section of the patient's blood vessel is not completely occluded. After all, the patient had undergone thrombolytic therapy before," said Xie Wanying.
"Oh." Lin Chenrong turned his head and waited for her to continue, "They are going to deal with the narrowness they found now, right?"
"It can be treated. But the main thing is to find intracranial aneurysms." Xie Wanying did not forget the surgical topic discussed at the previous neurosurgery meeting.
This little bit of stenosis is easy to deal with. However, to eliminate the embolus in the patient's body in the long run, it is necessary to start from the source, so that the patient's blood vessels will no longer produce embolus. If there is atrial fibrillation, treat atrial fibrillation. If there are other diseases such as high blood lipids and high blood pressure, take medicine for a long time after surgery. Surgery often solves the local symptoms but does not cure them.
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