Recently, the team of Director Qiao Zengyong of the Department of Cardiovascular Medicine of Fengxian District Central Hospital successfully carried out a cardiac stent implantation operation under the guidance of IVUS-OCT dual-modal endoluminal imaging, filling the gap of this technology in the region.
Huang Grandma was admitted to the Department of Cardiovascular Medicine of Feng Center due to chest pain, and the results of coronary angiography showed that Huang Grandma's coronary artery stenosis was more than 80% and calcification was severe, and Director Qiao Zengyong recommended that the patient be implanted with a stent. However, severe vascular calcification makes it impossible for doctors to accurately judge the nature of intravascular plaque based on coronary angiography image information alone, and if the stent is directly implanted, there is a possibility of stent adhesion and poor expansion, which affects the long-term prognosis of patients.
After full communication with Grandma Huang's family, Director Qiao Zengyong's team decided to perform IVUS-OCT dual-modal intraluminal imaging for further examination and guide the precise implantation of stents. Under the guidance of IVUS-OCT dual-modal endoluminal imaging, the surgical team accurately selected a stent with a suitable diameter and length, and after full expansion, the stent adhesion and expansion were ideal, and the operation was successful within 1 hour.
Before surgery
After surgery
IVUS and OCT are both the "sharp eyes" of coronary interventionists, which can enter the coronary artery to show the situation inside the blood vessels, so as to accurately guide the interventional treatment, and are essential tools for difficult coronary interventional surgery. However, IVUS and OCT images have their own advantages and limitations: IVUS has strong penetrating power and can show the overall structure and volume of coronary plaques, which is suitable for evaluating coronary artery main vessels such as left main and ostal lesions, but the resolution is not high. In contrast, OCT has a high resolution to clearly display tissue features (such as the type of plaque and the thickness of the fiber cap, thrombosis, neointial tissue, calcified lesions, etc.), which can accurately evaluate the position of the blood vessel wall, neointimal coverage and stent adhesion after stenting, but the tissue penetration ability is weak. However, if used sequentially, it will increase the financial burden of the patient and the risk of complications.
The "IVUS/OCT two-in-one" dual-modal imager integrates the advantages of IVUS and OCT imaging modes to achieve the effect of "combining two swords" - only one catheter needs to be used to present two images at the same time during the operation, and the two complement each other's advantages and complement each other's strengths, which will neither increase the cost of surgery, nor prolong the operation time, nor increase the pain and operation risk of patients, so as to carry out precise treatment for patients.
With the continuous development of the interventional era, endovascular imaging is becoming more and more important in coronary interventional treatment, and the Department of Cardiology of Fengxian District Central Hospital is also constantly improving its technology and pursuing breakthroughs. The successful development of this operation marks a new level of precision treatment for coronary heart disease in Fengxian District Central Hospital, and more patients will benefit from the "IVUS/OCT two-in-one" dual-modal imaging system to accurately guide the interventional treatment of coronary heart disease in the future.
Department of Cardiovascular Medicine, Fengxian District Central Hospital
The first batch of key medical disciplines in Fengxian District, Fengxian District Chest Pain Diagnosis and Treatment Center, Fengxian District Atrial Fibrillation Center and obtained the National Chest Pain and Atrial Fibrillation Center certification. At present, 85 beds are open (20 in CCU and 5 in Class A wards). There are 64 medical staff (1 doctoral supervisor, 3 master's supervisors, 5 doctors, and 10 masters), including 3 chief physicians, 5 deputy chief physicians, and 10 attending physicians. The annual outpatient and emergency business volume is 120,000 person-times, the annual discharge number is nearly 4,200 person-times, and the interventional diagnosis and treatment is more than 2,600 person-times. The sub-disciplines are mature, including coronary intervention group, pacing group, electrophysiology group, and hypertensive heart failure group.