Famous Among Top Surgeons in the 90s-Chapter 2010: High Risk
Yes, the catheter used in interventional surgery can only reach the proximal end of the ophthalmic artery for drug administration or stent placement. If there’s a blockage in these areas, it’s needless to say that placing a catheter and stent here is possible, and the effect of clot retrieval and thrombolytic therapy is relatively good.
The catheter and stent are limited by the diameter of the blood vessel and cannot be delivered to the terminal blood vessels supplying the retina. The only remaining question is whether thrombolytic medication can accurately reach the blockage location of the retinal artery through the ophthalmic artery to dissolve it; perhaps it can. But if thrombolytic medication is feasible, why bother with interventional surgery? It can be administered intravenously throughout the body in the same way.
As a leading figure in the industry, Doctor Hu’s ophthalmology attending physician understands the fundamentals of these surgeries and would not deceive a colleague like Doctor Hu. Preliminary examination suggests that Doctor Hu’s embolus is likely at the terminal end, and it’s feared that stent-based thrombectomy might not be successful.
All surgeries carry risks.
Research abroad has already been conducted, and the difference in treatment efficacy between intravenous thrombolysis and local interventional thrombolysis is insignificant. That’s the first point. The second point is that the risk of this ophthalmic interventional surgery is extremely high, with adverse incidence rates several tens of percent higher than those of intravenous thrombolysis.
This ophthalmic interventional surgery is not performed by ophthalmologists; ophthalmologists assist on-site, but an interventional physician from internal medicine is required to perform it. From the adverse incidence rates of the surgery mentioned above, it can be seen that this surgery demands a very high technical skill level from interventional surgeons.
Think about it, interventional surgery in the country is still catching up with foreign standards, and the training of interventional surgeons can be said to have not reached international standards. Truly having this level of ophthalmic interventional technology is very rare. Foreign experts are already achieving this, but finding such guaranteed expert doctors domestically is scarce. Furthermore, Doctor Hu has the extremely rare occurrence of bilateral rather than unilateral episodes, making the risk of interventional surgery even higher.
Finally, the effectiveness of previous intravenous thrombolytic treatment for Doctor Hu proved that not undergoing interventional surgery was correct. Because the embolus in the central retinal artery of Doctor Hu cannot be completely dissolved by thrombolytic medication. It’s as if undergoing local thrombolytic interventional surgery carries high risks without much use.
After hearing these words from the doctor, Mr. Liu hung his head, indicating that the information he gathered to help his wife was ineffective. 𝒻𝘳ℯℯ𝑤ℯ𝒷𝘯ℴ𝓋ℯ𝘭.𝑐ℴ𝑚
It’s normal for a non-expert to have fragmented and biased information from hearsay.
Perhaps his wife, Doctor Hu, already knew this and almost gave up.
Mr. Liu, with a face full of worry, earnestly pleaded with the doctor, "Many doctors recommended I come to you last night, Dr. Cao. Do you also have no way to help my wife’s illness? In fact, I didn’t quite understand what the doctors said last night. Is there a remedy for an ophthalmic condition in neurology?"
"I just explained the ophthalmic treatment part to you. Your wife received thrombolytic medication within a few hours, dissolving part of the embolus, which bought precious time for the doctors to consider more ways to treat your wife’s condition. Preliminary observation suggests that the remaining embolus in your wife seems to have calcification or cholesterol, which is why it cannot be dissolved. In such a case, the only solution is to find a way to extract the embolus," Cao Yong said. "Conditions like your wife’s often occur alongside strokes, already indicating a large connection between the two. Although Doctor Hu’s condition is an ophthalmic issue, anatomically, the arterial system supplying blood is said to belong to the category of neurology. The ophthalmic artery itself is a blood vessel that enters the cranial cavity."
