Common carotid artery stenting, for patients with common carotid artery stenosis.

The patient, 63 years old, was admitted to the hospital with recurrent episodes of dizziness for two months.

MRI showed severe stenosis of the right common carotid artery, and no new infarction was found on MRI of the brain.

Therefore, it was decided to perform carotid artery angioplasty stent implantation.

In patients with immediate disease, the common carotid artery is severely stenotized, more than 85%, so stenting is required to dilate the narrowed area.

Common carotid artery stenting is generally relatively simple.

But for Leng Chengye, this is the first operation he did by himself after all.

This bright star in the Massachusetts God will be nervous about a common carotid artery stent intervention.

As a helper, Yuntian stood opposite Leng Chengye, and this was the first time that Yuntian watched an operation from the perspective of the first stop.

For the surgical approach, Leng Chengye cautiously chose the femoral artery entrance, which is easier to do.

Local anesthesia, Leng Chengye is very essential.

Although there is still no way to compare it with Yuntian's standard, textbook-like local anesthesia technique, it can be regarded as decent.

At least it's much better than a large number of doctors who have only come into contact with internal medicine.

Next is femoral artery puncture.

Femoral artery puncture is a relatively easy access to arterial puncture.

The first puncture, after repeated exploration and confirmation, Leng Chengye determined the position of the femoral artery, but after all, it was the first femoral artery puncture, so Leng Chengye was a little nervous, and his hand was slightly offset to the outside by about two millimeters when he pulled the puncture needle.

The first puncture failed.

Leng Chengye wiped some of the sweat off his forehead with his shoulder.

He took a long breath.

When he looked up, he saw Yun Tian looking at him, and squinted his eyes embarrassedly.

"A little nervous. Leng Chengye explained with a little embarrassment.

"It's okay, come again. Tomorrow nodded and encouraged.

Re-sterilize, puncture again.

This time, it hit the nail on the head.

Leng Chengye stabilized the movements in his hand, deliberately raised his head, and looked at Yuntian proudly, like a second ha waiting to be praised.

"Not bad!" Yun Tian nodded in praise, but fortunately he couldn't resist the action of raising his hand to stroke Leng Chengye's head.

The puncture was successful, the vascular sheath was inserted, the loach catheter was placed, and the catheter was then placed into the right carotid artery.

Usually look at the clouds, tomorrow I can easily complete the puncture alone, enter the vascular sheath, and send it into the microcatheter.

But when it was Chen Yan's turn to do this kind of work by herself, it seemed a little disorganized and disorganized.

Especially when he saw the bleeding from the puncture needle, Leng Chengye panicked even more.

Don't blame Leng Chengye for not being calm.

Bleeding is often a more serious manifestation for physicians, so subconsciously a little nervous.

"Don't panic. Yun Tian comforted and reached out to hold the vascular sheath.

"Hmm. Leng Chengye took a deep breath and stabilized his somewhat flustered thread.

After all, it is the star of the gods in Massachusetts, and Leng Chengye didn't take much time

Calmed down.

The microcatheter was securely inserted into the vascular sheath.

The twisting microcatheter slowly moved forward, and the speed at which Leng Chengye was sent into the microcatheter was very slow.

Although the speed is very slow, the good thing is that Leng Chengye is very stable.

The loach catheter rests steadily at the right carotid artery entrance.

There is no need to remind Leng Chengye, and he will take the initiative to open the pressurized injector tomorrow.

With the injection of contrast medium, the carotid angiography appears clearly on the screen.

There is a marked stenosis at the beginning of the right carotid artery.

On the screen, the initial segment of the carotid artery is like a pencil sharpened by someone, leaving only the tip of the pen to connect the two ends of the carotid artery.

"The degree of narrowing of blood vessels is more than 85 percent. "It's consistent with the MRI image I did before.

Internal carotid artery stenting is confirmed.

According to the contrast images, select the appropriate microguidewire, microcatheter and stent.

Prepare for internal carotid artery stenting.

"You can shape the tip of the micro guidewire slightly, and adjust the shape of Windows slightly according to the condition of the narrow section, so that it is easier to pass through the narrow area. Seeing that Leng Chengye had almost prepared the corresponding consumables, Yuntian reminded him loudly.

After all, Leng Chengye is the first interventional operation, no matter how good his talent is, he is still a little nervous and at a loss.

Yun Tian's timely reminder at this time seemed to clear the clouds and mist for Leng Chengye, and he instantly became sober.

"Thank you. Leng Chengye thanked Yuntian from the bottom of his heart at this time.

After counting the consumables again, Leng Chengye took a deep breath and began to prepare.

First, the microguidewire is fed and the protective device is placed.

Protective devices, also known as protective devices, umbrellas.

Protection, the umbrella is enclosed in a specific lumen and must be passed through the narrow area by a microguidewire, fed distal to the narrow, and then opened.

In order to prevent the plaque that may fall off when the stent is opened, causing secondary embolism.

When the microguidewire reached the front stage of occlusion, Leng Chengye stopped.

Although there was a reminder tomorrow before that Leng Chengye had shaped the front end of the microwire, at this time, Leng Chengye still felt quite pressured to pass through the initial section of the carotid artery with a stenosis of more than 85%.

After about 5 seconds of slowing down, Leng Chengye took a deep breath and began to control the micro-guidewire through the narrow area.

After all, it is only a second-level operation, Leng Chengye has followed Yuntian to do so many surgeries, although he is only an assistant, but his familiarity and ability to perform surgery are incomparable to ordinary novices.

Therefore, Leng Chengye passed through the carotid artery stenosis area without danger.

Continuing on for the mentor, he stopped at the far end of the narrow.

Open the umbrella.

At this point, the risk of further stent dilation at carotid stenosis is much smaller.

into the bracket.

Adjust the position.

"Move forward by 0.5 mm. Leng Chengye was about to open the bracket when Yuntian suddenly reminded him in a loud voice.

"Move forward 0.5 mm?" Leng Chengye was a little surprised.

I just chose it

The location where you think it is most appropriate to open the bracket.

But Yuntian actually allowed himself to move forward by 5 mm?

Obviously, if the stent is moved backwards at this time, it will obviously deviate from the position of the plaque.

That's why Leng Chengye repeated in surprise.

"When you do it, your hand will have a certain habit of moving, which will cause the position of the bracket to deviate, and your hand will be used to pushing backwards. "Tomorrow will be explained simply.

Your own habits?

Leng Chengye felt cold sweat on his forehead.

I didn't even notice what I was doing.

Tomorrow, just by watching myself have half an operation, have you already figured out your own habits of surgery?

This is outrageous, isn't it?

Do demons have to flaunt their differences like this all the time?

Can you save some face for yourself?