Reasoning diagnosis: Big brother, your wife has been prescribed medicine!

Chapter 207 Find out the cause, surgery is easy!
After going out, Lin Yi arranged for the man to be pushed into the examination room.

After the angiography is performed, the presented image is displayed directly on the screen!

Wu Jiang and the emergency doctor stared at the screen closely, looking at each picture carefully.

Suddenly, everyone couldn't help taking a deep breath, and stared straight at the screen.

"This this……"

Wu Jiang pointed to a picture on the screen, and his voice trembled uncontrollably.
"Brother Yi, you are so awesome!"

"You're really right! He did have a ruptured brain aneurysm."

"Although the brain aneurysm is very small, it can still be clearly seen on the image!"

Immediately afterwards, the emergency doctor couldn't help but said:
"His current condition is subarachnoid hemorrhage, and the bleeding tends to increase. He has multiple grand mal seizures, which are caused by bleeding!"

After speaking, everyone finally breathed a sigh of relief.

Finally found the cause of the patient!
Then the next thing to do is treatment!
Immediately afterwards, the emergency doctor couldn't help but frowned and looked at Lin Yi, and said:

"Since it is confirmed that this patient has a ruptured cerebral aneurysm, then an interventional operation will be performed?"

"I'm going to contact the neurointerventional department now and ask them to perform the operation?"

Lin Yi was silent for a moment, then waved his hand and said directly:

"No, we took so much effort to diagnose his cause, there is no need to transfer him to the neurointerventional department."

"I'll take care of his cerebral aneurysm embolism. You go tell the family members and ask them to sign the operation agreement, and prepare to operate on him immediately!"

"This...Okay, then I will go to the patient's family now!"

The emergency doctor was taken aback for a moment, then nodded.

Although he had heard of Lin Yi before, he didn't know about Lin Yi's surgical ability.

I don't know that he stunned all the experts in the neurointerventional department before!
But then, he couldn't help getting a little excited.

Because he was finally able to go to the patient's family to feel proud!

I was almost shut up by them just now!

Afterwards, the emergency doctor went out directly and walked to the ward.

Lin Yi asked Wu Jiang to call Song Borui, and asked him to perform the operation with him later.

This patient is going to have aneurysm embolization, an interventional procedure.

Lin Yi didn't dare to delay, and directly arranged all the surgery matters,
For subarachnoid hemorrhage caused by ruptured cerebral aneurysm, interventional surgery should be performed as early as possible.

Because of the rupture of the cerebral aneurysm, there is a possibility of secondary bleeding!
If it does bleed again, the condition will become very bad and seriously life-threatening!
In fact, this kind of brain aneurysm interventional surgery is difficult and easy to say.

This type of intervention requires only two people.

After everything was ready, the patient was pushed into the operating room.

Lin Yi stood in front of the operating table, next to the patient's right thigh.

Cerebrovascular interventional surgery generally chooses femoral artery puncture.

On the one hand, it is safer here, and on the other hand, the blood vessels are relatively thick, which is easy to operate.

"Old horse, perform anesthesia!"

Lin Yi stared at the patient on the operating table and said something, heralding the start of the operation!
"it is good!"

The old horse nodded in agreement, and then began to inject anesthesia.

After the anesthesia, Lin Yi was unambiguous and moved directly.

He took the femoral artery 1.5cm below the midpoint of the patient's right inguinal ligament as the puncture point, and used the Seldinger technique to puncture the right femoral artery.

One shot is a success!

This piercing action can be said to be very simple for Lin Yi!
Song Borui watched closely the movements of Lin Yi's hands.

Song Borui is not very skilled in interventional surgery,
Generally, when encountering such patients, they are directly transferred to the neurointerventional department.

So now he is doing surgery with Lin Yi, which is also a good learning opportunity.

Lin Yi kept moving his hands, used the replacement guide wire, inserted a 6F catheter sheath, and then injected 30 mg of heparin intravenously for anticoagulation.

"Heparin must be administered, and we must not forget it, otherwise blood clotting will easily occur."

When some key steps are reached, Lin Yi will give some explanations to Song Borui next to him.

Song Borui listened and nodded repeatedly.

Subsequently, under the guidance of a 0.035-inch guide wire, Lin Yi inserted a 6F guiding catheter along the catheter sheath to the right internal carotid artery.

Immediately afterwards, Lin Yi couldn't help pointing at the image on the monitor, and told Song Borui:
"When you do this step, you must be extra careful. You must not puncture the internal carotid artery, otherwise the patient will die immediately!"

This step is the key point among the key points.

If the operation force is too strong and the carotid artery is punctured at that time, it will immediately cause massive hemorrhage of the carotid artery and endanger the life of the patient.

So this embolization seems to be quite simple, but there are many key points in it, and it needs to be treated with extra care.

"Well, I see."

Song Borui nodded repeatedly, expressing his understanding.

Afterwards, Lin Yibian withdrew the guide wire, guided the catheter along 6F, and placed the SOLITAIRETM-AB (18mm×4mmev20) endovascular stent in the neck of the aneurysm with the RebarTM-3 intravascular stent delivery system. Inside the artery, fix the stent position.

Lin Yi's operation speed was extremely smooth without any pause.

But in Song Borui's eyes, it was fast and dangerous.

He watched Lin Yi operate, keeping his heart in his mind, for fear of accidentally puncturing the patient's blood vessels.

But where Song Borui looked dangerous, Lin Yi could indeed operate with ease.

This made Song Borui even more amazed by Lin Yi's surgery technology!
This cerebral aneurysm embolization is really nothing to Lin Yi, who has expert surgical techniques.

Soon, the operation was halfway through.

All that remains is to place the four coils into the ruptured aneurysm.

Lin Yi then guided the catheter along 6F, and under the guidance of the SilverSpeed-14(ev3) microguide wire, the EchelonTM-10(ev3) microcatheter tip was selectively inserted into the tumor through the right internal carotid artery.

经血管内弹簧圈栓塞术，放入Helix(8mm×30cm;ev3，Axium)、Helix(7mm×20cm;ev3，Axium)、Helix(6mm×20cm;ev3，Axium)、Helix(5mm×15cm;ev3，Axium)这4枚弹簧圈。

Because the diameters of these four spring coils gradually increase, the one with the largest diameter should be placed first.

The coils have all been placed in the aneurysm body, the operation is basically completed, and the remaining work is to do an angiography to see how the effect is.

While injecting the contrast agent, Lin Yi said to Song Borui next to him:

"Now the coils are basically densely filling the tumor body, showing that the tumor body has disappeared, and the right internal carotid artery and the middle and anterior cerebral arteries are well developed."

"At this point, we can release the stent!"

As Lin Yi spoke, he immediately released the stent, and then administered a contrast medium.

(End of this chapter)