Famous Among Top Surgeons in the 90s

"You're right." As the class monitor, one must be straightforward when the moment calls for it. Yue Wentong announced on the spot that Student Pan's speculation about the patient's basic condition was correct and continued to outline the patient's self-reported medical history. "The patient previously underwent an interventional procedure at Zhongshan First Affiliated Hospital's Cardiology Department. A few months ago, it seemed the situation wasn't too serious, and there was no emergency intervention; the patient just felt some discomfort in the chest and sought medical attention at the outpatient clinic. Later, an angiographic examination revealed a significant narrowing of the left anterior descending coronary artery. According to the patient's account, the doctor described the stenosis as quite serious, so a stent was placed after balloon dilation."

That's her hometown, thought Xie Wanying.

"As for why it restenosed?" Yue Wentong said this while glancing at Student Feng.

Is this question really necessary?

In-stent restenosis is very common. Furthermore, did he just say the patient was brought to the emergency room due to in-stent restenosis?

Feng Yicong blinked at the ceiling, hating himself for speaking without thinking. The class monitor is a top student in the class, second only to the female top student, Yingying.

How could he immediately suspect in-stent restenosis without the patient having undergone coronary angiography? Maybe it was due to another artery being blocked, or perhaps for some other reason.

Pan Shihua swallowed a bite of food and spoke a fair word for Student Feng, "It's possible he returned to the emergency room months later, and a few months prior, other vessels were fine after the angiography. The likelihood of something happening again inside the stent should be relatively high. — Yingying, what do you think?"

Asked for her opinion by her classmates, Xie Wanying recalled that drug-eluting stents had not yet hit the market during this period, making bare-metal stents prone to restenosis, thus becoming a major obstacle in stent surgery. Actually, the direction of the two students' inquiries was correct. It's just that the class monitor is a very cautious person who wouldn't make random guesses before the angiographic results are out. Perhaps it's because emergency cases of in-stent restenosis are quite common, indicating that this reason is unlikely the specific feature that requires Senior Jin to come down specifically.

"The class monitor hasn't finished speaking," Xie Wanying said.

Pointed out by her that he hadn't finished his words, Yue Wentong paused, giving her a slightly meaningful look. It seems both classmates have somewhat intuitive insights. The difference is, Student Pan's speculative logic belongs to the superficial level, while their class's female top student's speculative logic belongs to the deep level, with brain secrets unknown to others.

"The teachers have decided to perform a radial artery puncture on him," Yue Wentong stated the crux of the matter.

"Not through the femoral artery, going through the radial artery, why?" Unafraid of being educated by the class monitor again, Feng Yicong asked.

The surgical routes for PCI are generally these three: femoral artery, radial artery, and brachial artery.

Among the three arteries, don't be misled by the fact that the femoral artery is farthest from the heart; it is the thickest and easiest to puncture and insert the guidewire. The radial and brachial arteries are somewhat closer to the heart, but unfortunately, they have smaller vessel diameters, and there are several hurdles along the path to the heart's coronary arteries, making the road less smooth than the femoral artery, which makes it not so easy to succeed.

Clinicians typically prefer the femoral artery as the surgical route if there are no special circumstances. Choosing the radial artery is bound to be triggered by an arterial condition in the patient that contraindicates the femoral artery approach.

"Does the patient have arteriosclerotic occlusive disease? Taking anticoagulants?" Pan Shihua pointed out possible reasons.

Student Pan's performance in class is equally excellent; otherwise, he wouldn't have also entered clinical practice in the advance batch.