Huashan Hospital, the magic capital.

Cardiology, operating room.

Guo Hongbo, academician of engineering and director of the cardiology department of the Chinese Academy of Sciences, is performing coronary artery stent intervention on a 60-year-old patient!

This patient is a CTO patient, that is, a completely occluded coronary lesion!

This patient, Academician Guo, did it once for the other party last month, but failed!

The main reason is that the patient's calcified occluded vascular guidewire cannot pass, so the operation cannot be successful!

At this time, Academician Guo was pushing the arterial guidewire to the patient's heart blood vessels little by little, and outside the operating room, more than 30 cardiology interventional experts from all over the world were watching carefully.

This operation is Academician Guo's teaching demonstration surgery to this group of experts, and it is also his second challenge to this ultra-difficult operation!

Guo Hongbo, Director of the Department of Cardiology of Huashan Hospital, Academician of Huaxia Science and Engineering!

His name is also thunderous internationally!

This is also the reason why experts from dozens of major hospitals outside watched his operation with bated breath.

Because they can learn the knowledge they need from Academician Guo's surgery!

This operation is very tricky, and even Academician Guo's first operation ended in failure, and it can be seen that it is now the second challenge!

The purpose of the surgery is to open the occluded area through the guidewire, then insert the microcatheter, and then install the stent along the microcatheter!

It's easy to say, but it's hard to do!

Because chronic total occlusion (CTO) lesions are recognized as difficult aspects of coronary intervention (PCI) and were once contraindications to PCI.

Now if you want to unblock the two occluded blood vessels, you must let the guidewire enter the occluded blood vessel from the front, why enter from the front, because the front entry guidewire is the closest to the heart blood vessels, the time is also the fastest, and the difficulty of the operation is much lower!

Academician Guo Hongbo is worthy of being an old driver, and the arterial guidewire soon reached the completely occluded calcification of one of the blood vessels!

Started an attempt to puncture the calcified area completely with an arterial guidewire, but failed!

The calcification is so hard that it stays in the middle of the blood vessel like a boulder, and it can't be pierced through the arterial guidewire!

Academician Guo tried to replace a slightly harder arterial guidewire, but after some triing, it still couldn't pierce through!

"The calcified lesion is too hard, it seems that the front side will not work!" said a deputy director of the cardiology department of Yangcheng Hospital, shaking his head. In principle, when encountering a relatively hard calcified lesion, you can use a stiffer arterial guidewire to penetrate it, but the reality is not absolute!

That's why this surgery is tricky!

"Academician Guo should be trying to reverse pierce!" said a director of the cardiology department of Tianjin Hospital.

If you compare the blood vessel to a tunnel, when you are faced with the direct entrance of the tunnel because you can't go in and dredge it because of the blockage, you want to find the passage from the auxiliary passage next to the tunnel to enter the tunnel, and the other end of the detour blockage is pierced and dredged in reverse!

That's the idea of the reverse approach!

Obviously, the difficulty of reverse approach surgery is definitely much more difficult than that of forward surgery!

However, connected to the occluded artery are many small collateral vessels, and these small blood vessels are 'auxiliary channels'!

What Professor Guo has to do now is to find a suitable passage from these many collateral vessels for the arterial guidewire to pass through, and successfully bypass the occlusion to the other end of the lesion!

Academician Guo's operation was precise and safe, but he tried three collateral vessels in a row, but they all found that it didn't work!

"Alas~ These collateral blood vessels are not good, they are too small to pass at all!" Guo Hongbo sighed.

Dozens of experts from all over the world who watched the live broadcast of the operation outside were speechless.

No way, these collateral vessels are too small!

The collateral vessels are complex and small, and the thin arterial guidewire is like entering a labyrinth.

However, Academician Guo did not give up, and still tested those collateral vessels one by one, wanting to see which one could work!

Outside, everyone was still watching intently.

"This side branch cycle doesn't work, let's try this!"

"This doesn't work either~"

"We seem to have tried this before, try this!" Professor Guo muttered as the nurse wiped his sweat.

Surgery, before you know it, three hours have passed!

"Whew...... I don't believe this! Reverse guidewire, reverse side branch will not work!" Academician Guo smiled helplessly, although he didn't want to give up, but the difficulty of this operation was really unprecedented!

The front will definitely not succeed, but to continue to enter the reverse direction, we must find a passage in the blood vessels that are farther away! But there are two completely different possibilities for the intersection formed by each small blood vessel, which can be passed or not!

Before you know it, another hour has passed.

At this moment, Guo Hongbo wanted to give up, and he said to the dozens of experts watching the live broadcast outside the window: "Comrades, who can tell me what to do? What do you have to do?"

The dozens of experts outside were silent after a pause.

No one has any good advice!

Because Academician Guo is an internationally renowned cardiology expert, even he can't do it himself, how can they do it?

"Well, is the operation going to end in a second failure?" sighed one of the doctors.

"This surgery is so difficult!"

"Let's try to prove entry again!" Seeing that no one suggested, Academician Guo sighed, a little helpless.

However, when I tried to enter head-on again, I still found that the calcified area was too hard!

"Oops~ It's so hard, it won't work!"

"This completely occlusive calcification can be simple or very complex, this is very complicated!" said the director of the cardiology department of Zhongshan Hospital in Modu.

Complete occlusion is the CTO, but the CTO is also difficult.

Obviously, this one let Academician Guo try to operate for the second time, which proves its complexity and difficulty!

I tried seven or eight more collateral vessels, but it still didn't work!

"Do you really have no suggestions?" Academician Guo stopped what he was doing and looked at the dozens of experts outside.

At this time, Jia Yanguan, the interventional department of the First Affiliated Hospital of Modu, was also there.

He is also one of many experts.

He came here today to observe Academician Guo's surgery.

"Academician Guo, I have a small suggestion~" Jia Yanguan raised his hand weakly.

"Oh, Director Jia, what do you suggest?" Guo Yuan glanced at Jia Yanguan outside the window, slightly surprised.

"If you have your permission, I suggest that you can ask Dr. Ruan Bin from my hospital to come over and do this surgery, I think he may have a way!"