The patient, a 47-year-old man, was admitted to the hospital with recurrent episodes of dizziness and sensory impairment.

Yun Tian inquired about the patient's illness and began to examine the patient.

"Doctor Xiaoyun, this is the third time I've come to your department to be hospitalized, and it looks like I'll have to get an annual card next time. Can you give me some discount?", the patient joked lightly.

"Do you usually feel dizzy and black in front of your eyes?" Yun Tian smiled.

Although the patient said it easily, who really wants to go to the hospital twice in three days, and it is not good to eat and live.

"Yes, every now and then. Sometimes it's dark in front of my eyes, and I'm sick and I've been having seizures for years. The patient replied.

After Yuntian did the physical examination, he carefully checked the patient's first two discharge records.

After each treatment, the symptoms were relieved, but they recurred shortly after discharge.

"Let's do a 64-slice carotid angiography. Yun Tian said after reading the patient's previous examinations and the discharge summary.

"Carotid angiography?" the patient was somewhat confused.

"Am I not having a cerebral infarction, and what does it have to do with the carotid artery?" the patient asked Yuntian.

"The arteries in the brain are like the twigs of a tree, and the carotid arteries are like the big trunk of a tree, and if the main stem is blocked, the blood supply to the twigs will be insufficient, the blood flow will be reduced, the blood flow will slow down, and it will often be easy to block. Yun Tian explained in succinct and clear words.

The image of Yuntian said, so the patient understood it at once.

"Then I'm the main trunk blocked? Is there a way to fix it for him? Is it good after repairing? I don't need to come to you often to report, and I don't need to pay for the year?" The patient's mentality was good, and he asked Yuntian with a smile.

"Let's check first. You have to look at the results of the examination to find out. Yuntian replied.

After asking the patient's past medical history in detail, Yun Tiancai returned to the doctor's office and began to write the medical order.

From the patient's condition, there is a high chance of arterial stenosis.

In such a situation, no matter how the patient dissolves thrombolysis and anticoagulation, there is no way to solve the problem of recurrent infarction.

Zhou Weihua is only 47 years old, and he has not even reached retirement age, so repeated infarctions will seriously damage his cranial nerve function, resulting in vascular dementia and even major infarction and other conditions.

With conservative medication in internal medicine, no matter how good the doctor is, he can only watch the patient get worse little by little.

There are only two ways to fundamentally solve carotid artery stenosis, one is surgery, carotid endarterectomy. The blood vessels are cut from the patient's neck to separate the strong arteries, and then the carotid arteries in the stenosis are cut to remove part of the carotid artery endomelia in it, so as to effectively improve the circulation of blood vessels in the neck and improve the intracranial blood supply in a short time.

However, the risk of such surgery is relatively large, because of the problem of intraoperative microembolism, it is easy to be complicated by surgical hemiplegia, facial paralysis, and even cognitive function decline after surgery.

Surgery is a relatively old type of surgery, and because of the high probability of complications, it is now done relatively rarely.

There is also one in the carotid artery

Interventional surgery to place a stent in a stenosis.

It is also the surgical method that Yuntian prefers.

Carotid artery stenosis is mostly due to atherosclerotic plaque blockage, and a spring stent is placed at the stenosis to stretch the blood vessels, so that the carotid artery blood flow can be effectively restored, so as to achieve the purpose of improving intracranial blood supply.

The carotid artery is located in a special location, and the blood vessels are relatively thick, which is easier to overselect blood vessels than the last time a pulmonary angiogram was performed on a cloudy day.

However, carotid artery stent surgery has not been carried out in China for a long time, and the cardiac stent surgery in Xihua Hospital has just been carried out, so there is definitely no energy to do carotid artery stenting.

I have not been exposed to the stent surgery at all.

But now I still have an intermediate skill book, a general energy technology book, and dozens of hours of intensive training time.

It should be enough to learn about carotid artery stent surgery.

However, neither the Kaminai nor the Department of Traditional Chinese Medicine has ever carried out such a treatment plan.

Carrying out a new treatment plan is not a trivial matter for a department, let alone carrying out interventional catheter treatment that most internists are confused about.

It seems that this matter has to be communicated with the two directors well.

Director Lin took everyone in the department to shabu-shabu.

Director Lu and Director Lin actually came back together, bringing Yuntian two large boxes of dishes, plus a meal.

The weather is getting colder, and the food will be cold in less than half an hour after it is brought out.

But when Lu opened the box, the food was still bubbling.

"I found a few big boxes with boiling water, put the packing boxes in boiling water and warmed them, right?" Lu smiled and looked at the food very satisfied, like a little doll waiting for praise from adults.

"Let go of the water and warm it, how did you get here all the way?" Yun Tian smiled as he picked up the lunch box and started eating.

"In the car, I have good driving skills, not only did I not spill any water, but the water did not enter the packing box. Speaking of this, Lu became even more proud.

"How did you come up with such a solution? It's really amazing!" Yun Tian was kind and praised the little girl verbally.

"Yes, it's amazing, it's amazing! I won't be allowed to sit in the co-pilot, and I, the section director, don't have a box of lunches. Looking at the two little guys, it was obvious that you were looking like a nong, and Director Lin quipped.

"That, the rice is cold, and it hurts my stomach to let Dr. Xiaoyun eat it when I come back. Lu, who was praised by Yuntian, was almost able to fly, but was teased by Director Lin and explained with a red face.

"Zhou Weihua, is he hospitalized again?" asked Lu with a blushing face, his eyes just catching a glimpse of Yun Tian's unfinished case.

"Zhou Weihua, is it a famous patient?" asked Director Lin suspiciously.

"This should be the third time he has been admitted to the hospital, right? One day he happily said that he wanted to buy himself a hospital package annual pass, and the last time he was discharged from the hospital, I told him not to come back in the future, it seems that it has not been a month yet, right?" Lu seemed to be very familiar with the patient's condition.

"It's been less than four months since our TCM department admitted inpatients, so we have such die-hard fans?" Director Lin's focus always seems to be a little biased.

"He should have severe intracranial blood supply caused by severe carotid artery stenosis, plus diabetes, hypertension, and poor blood circulation, so he will have repeated infarctions. If the problem of carotid artery stenosis can be solved, the situation should be greatly improved. Yun Tian was thinking about this and explained to the two of them.

"Carotid artery stenosis is currently very poorly treated conservatively, and it seems that it is really necessary to apply for an annual card for him. "Director Lin really has a peculiar concern.

"Even with surgery, the incidence of postoperative microembolization after carotid endarterectomy is very high, and there are quite a lot of complications, and the benefits are not high. After all, Director Lin is well-informed and casually mentions carotid endarterectomy.

However, even if it is surgical, it is also risky, and the benefits are not high for patients.

"What if I have carotid interventional stenting?" said Yun Tian, swallowing a large mouthful of food.

"Carotid stent, will you do interventional surgery? Yes, last time Don wanted to poach you. ”

"At present, only Lao Tang can go on stage on the other side of the heart, and he can't finish the heart stent alone, and the catheterization laboratory is idle for most of the time. Director Lin thought in pieces.

"Xiao Wangcai, you first complete the examination of the patient, and I will go back and discuss it with Lao Shi. After Director Lin finished speaking, he grabbed his small bag and left quickly with his high heels.