Capítulo 1634: Chapter 1634: Technology Comparison
“It’s for IVUS.” Shim Youhuan slamd his fist into the palm of his hand, finally recalling there was such a specialized examination, he said, “I initially thought she wanted to do esophageal ultrasound, thinking this wouldn’t have been done already, unless it’s done again during surgery?”
IVUS is intravascular ultrasound, which can also be used to examine the intravascular condition of the coronary arteries. Unlike coronary angiography, it doesn’t require the use of contrast agent for visualizing the thickness of the blood vessels. Instead, a miniature ultrasound probe is directly inserted into the blood vessel to detect the internal condition of the vessel. Further examination can be carried out with future OCT, utilizing infrared to asure blood vessels, which offers higher precision than IVUS.
Why aren’t these latter two technologies commonly used in clinical practice? The main reason is just one: cost.
Relatively inexpensive coronary angiography already brings very good efficacy, so why use these two technologies? Moreover, after these two technologies are used for detection, stent placent still requires angiography technology. It equals a doubled cost, but with not much difference in efficacy. Doctors mindful of ordinary folks know which option to choose.
It’s not that these two technologies are not used clinically. Any technological invention that survives must have its irreplaceable usability.
Both IVUS and OCT surpass coronary angiography in precision by quite a margin.
This high precision can be used in many complex cases.
For example, a patient displays typical clinical symptoms, but coronary angiography finds that the degree of vascular narrowing doesn’t et stent placent criteria, hovering at the borderline. Legally, if doctors place the stent, it constitutes over-dication which could lead to lawsuits for other aftereffects. The patient’s symptoms remain unresolved, bringing additional high risks. Doctors can only seek other evidence, at which point IVUS might play a critical role in detecting narrowings that coronary angiography can’t see.
Because coronary angiography results only show the size of the coronary lun, they cannot detect the vessel wall, leading to underestimation of the severity of vascular narrowing.
Coronary heart disease patients mostly have arterial sclerosis plaque-induced narrowings, only IVUS can detect early vessel wall sclerosis plaque to inform doctors of the severity of lesions in the area, providing an earlier prompt for stent placent compared to coronary angiography.
Likewise, for so young patients displaying coronary heart disease symptoms, angiography indicating serious narrowings, doctors know they might not have the age basis for atherosclerosis, yet failing to place stents could also constitute dical malpractice liable for litigation. Using IVUS to asure the condition of the vessel wall can help doctors find more precise evidence for judgents. In cases of mild vessel wall lesions, initially clearing the thrombus and determining stent placent only after a certain period is not overdue, avoiding over-treatnt is best not to over-treat.
Regarding Xiao Shugang, with coronary angiography, it’s not necessarily possible to see narrowings or identify which sections are narrowed if a stent is not strictly necessary. What needs closer inspection is the condition of the vessel wall, to check for traces of post-accident damage.
“The issue is that this examination I perford can only look from the inside, not from the outside.” Shim Youhuan engaged in academic exchange through Student Pan and Student Xie.
“Yingying said the inside and outside are connected, allowing determination of the surgical area to be addressed.” Pan Shihua said.
“Is she suggesting we first resolve the issue of the restricted surgical area for the patient?” Shim Youhuan asked.
“She ans the heart’s blood supply area must be addressed first.” Pan Shihua replied.
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