Famous Among Top Surgeons in the 90s-Chapter 2009: The Boss Was Not Careless
"I’ve heard people mention these things before, and after coming home, I flipped through the medical textbooks my wife keeps at home," Mr. Liu, also a highly educated individual, could understand part of what the doctor was saying.
Seeing that the family member could communicate, Cao Yong delved into more advanced knowledge: "The most important characteristic of the retinal artery network is its very narrow vessel diameter. At this stage, no catheter can reach this place, and it would be very problematic if there were an embolism here. Doctors have limited strategies to respond to this."
"Yes, but I’ve heard people say that a blocked vessel can undergo thrombolysis and thrombectomy." Mr. Liu asked around and shared all the information he gathered to save his wife, not wanting to miss any opportunity for her treatment.
Thrombectomy and thrombolysis, Mr. Liu’s words likely referred to the ophthalmic intervention. The pathogenesis of this condition is similar to a myocardial infarction, and similar interventional techniques, such as pharmacological thrombolysis and catheterization, could be used. However, it has been mentioned that ophthalmology cannot perform such interventions, which is why.
"Whether it’s thrombolysis or catheter intervention for thrombectomy, timeliness is crucial," Cao Yong did not completely deny the information obtained by the family member but spoke truthfully, indicating that the information received by a layperson might lack professionalism and might contain errors. "Generally speaking, immediate treatment within a few hours after onset yields the best results. Your wife, Doctor Hu, being a doctor herself, understands this is an acute illness, and promptly sought an ophthalmologist for emergency care was the right choice. And because of your wife’s timely self-help, the completely blind result did not occur, and now the embolism is partially immobile. From the ophthalmology records, this seems to be the situation. In the previous steps, ophthalmology didn’t perform angiography on her, and would not have considered interventional thrombectomy thrombolysis at that time."
"Why didn’t ophthalmology perform the surgery on my wife?" Doctor Liu pressed on, suspecting a lack of diligence or assertiveness in the ophthalmologist’s treatment.
The ophthalmology boss, knowing the patient is a colleague, wouldn’t dare to be careless, as one cannot fool peers.
Cao Yong smiled, not defending his colleagues but clarifying for the family: "The effect of intra-ophthalmic artery thrombolysis is far less effective than myocardial infarction intervention. The retinal artery is a terminal vessel, as I mentioned earlier, and its vessel diameter is too narrow, with no equipment available to break the physical limit and enter this place. Doctors cannot deliver a catheter to such a precise location like in cardiovascular interventions for thrombectomy thrombolysis and stent placement, so the surgical effect is questionable."
Specifically speaking, cardiovascular interventions can deliver catheters and stents to the main coronary artery supplying the myocardial cells, achieving precise treatment like a missile hitting the target site, and the effects of thrombectomy thrombolysis surgery are naturally immediate. The central retinal artery is too narrow to achieve this, and its interventional surgery can’t be considered a true intervention.
As such, ophthalmology doesn’t often perform these interventions, but it’s not nonexistent. It depends on whether the patient’s condition meets the surgical indications. Doctors choose to perform intra-ophthalmic artery interventions on some patients mainly considering the possibility that the embolism isn’t in the retinal artery but in places like the internal carotid artery or proximal ophthalmic artery.
