BXBX NOVEL Chapter 1634: 【1634】Technical comparison
IVUS is an intravascular ultrasound, which can also check the intravascular condition of the coronary arteries. The difference from coronary angiography is that it does not need to use contrast agent for fluoroscopy to visualize the thickness of blood vessels, but directly sends a micro-ultrasound probe into the blood vessels to detect the internal conditions of the blood vessels. Further examinations include future OCT, which uses infrared to measure blood vessels with greater accuracy than IVUS.
Why are the latter two techniques not commonly used in clinical practice? The main reason is only one, expensive.
Relatively cheap coronary angiography can already achieve good results, why use these two techniques. Besides, after these two technologies are detected, the imaging technology still needs to be used to place the stent. The cost is doubled, but the effect is not much different. Doctors know which one to choose for the sake of ordinary people.
These two techniques are not clinically used. As long as any technological invention can survive, it must have its irreplaceable usability.
IVUS, like OCT, is much more accurate than coronary angiography.
This high accuracy can be used in many difficult cases.
For example, a patient has typical clinical symptoms, and coronary angiography finds that the degree of stenosis of the blood vessel is less than the requirement for stent placement. Legally, if a doctor puts a stent on a patient, it will be accused of excessive medical treatment and other sequelae. Patients with unrelieved symptoms carry other high risks. Doctors can only look for other evidence, at this time IVUS may play a key role, IVUS can not be seen by coronary angiography.
The reason is that the result of coronary angiography is only the lumen size of the coronary artery, and the inability to detect the vessel wall leads to underestimation of the severity of vessel stenosis.
For patients with coronary heart disease, most of them are stenoses formed by atherosclerotic plaques. Only IVUS can detect early vascular wall sclerosis plaques and tell the doctor the severity of the local disease. It is a step earlier than coronary angiography to prompt the need for stent placement.
The same thing. For some young patients who have coronary heart disease symptoms and angiographic evidence of severe stenosis, doctors know that they may not have the age basis for atherosclerosis. At this time, if the patient is not placed in a stent, it is medical negligence and may also be accused of negligence. Using IVUS to measure the condition of the blood vessel wall can help doctors find more precise evidence to make judgments. In the case of minor vascular wall lesions, the thrombus should be cleared first, and after a certain period of time, it will be time to decide whether to place the stent or not. It is better not to over-treat.
On the patient Xiao Shugang, coronary angiography may not be able to see the stenosis or see which segment of the stenosis is not necessarily a stent. What needs to be checked is the condition of the blood vessel wall to see if there is any trace of damage after the car accident.
"The problem I'm doing this check for him can only be seen from the inside, not from the outside."
"Yingying said that the inside and outside are connected, so you can determine which area of the surgery is to be done." Pan Shihua said.
"Does she mean to solve the patient's limited surgical area first?" Shin Woo-hwan asked.
"She means that the blood supply area of the heart must be solved first." Pan Shihua said.
(end of this chapter)