In our body, there is a large blood vessel directly connected to the heart and runs endlessly like the Yellow River of the Yangtze River every day to the whole body - the aorta. It starts from the left ventricle, which is the only way for blood to reach the whole body, and once it has a problem, it may affect the blood supply to the relevant parts of the body, and even endanger life.
"For example, aortic aneurysms and aortic dissection, both of which cause the aorta to dilate, are more dangerous. Once the aorta ruptures, the mortality rate is as high as more than 80%, so it is called the 'time bomb' in the human body. Professor Wang Haiyang, a department of vascular surgery at the First Affiliated Hospital of Guangzhou Medical University, reminded that early detection and early intervention are the key to staying away from the potential risks of aortic aneurysms and aortic dissection. Early detection of these diseases can be controlled by controlling blood pressure, anti-arteriosclerosis therapy, and improving lifestyle habits. However, if the aorta dilates to a certain extent, active intervention is required as directed by a doctor. Even if surgery is required, there is no need to worry too much, and the minimally invasive interventional surgery currently used in the clinic can be effectively treated with fast recovery and less bleeding.
Case: Abel's leg is weak, and he has a huge "tumor" in his abdomen.
More than a month ago, 73-year-old Zhang Bo's legs stood up very hard, feet like lead, stood up and wanted to move, each time had to stay for more than ten seconds before he had the strength to take a step, to the hospital to check, the doctor found that he had a diameter of about 10 cm in the abdomen aortic aneurysm with a maximum diameter of about 10 cm!
"It's like an 'untimed bomb', it can explode at any time, and it needs surgery as soon as possible!" Wang Haiyang led the team to immediately arrange for him to do a minimally invasive abdominal aortic aneurysm endoluminal isolation.
During the operation, the doctors found that the "tumor" in Zhang Bo's body was like a balloon that was blown to the extreme, and the amount of blood stored in the "tumor" was thousands of milliliters, which had affected the function of important organs such as his heart, and at the same time caused insufficient blood supply to the lower limbs and weak walking. What is more dangerous is that this expanded blood vessel wall has been hit very weakly by the blood flow, if there is no timely operation, once the blood flow breaks through the outer wall of the blood vessel, like a levee, heavy bleeding, shock, death is likely to be a matter of an instant.
On the day of the operation, in the state of local anesthesia, Professor Wang Haiyang's team sent the mulching stent to the abdominal aortic aneurysm site through the piercing eye at the root of Zhang Bo's thigh, and used a special slender catheter to reconstruct an "artificial channel" for blood flow, completely isolated from the abdominal aortic aneurysm, and successfully "defused". After the operation, Zhang Bo quickly recovered and was discharged from the hospital.
Interpretation: This "tumor" is essentially different from a tumor
As soon as they hear that a "tumor" is found, many people will think of tumors. In this regard, Wang Haiyang explained that although the aortic aneurysm also has a "tumor" word, it is essentially different from the tumor, which refers to the abnormal expansion and bulging of the aorta locally, rather than the substantial cell proliferation or even malignancy like tumors and cancers.
After figuring out that this "tumor" of the aorta is not the other "tumor", many people will breathe a sigh of relief and feel less dangerous. Not really!
"Aortic aneurysms are like invisible 'time bombs' in the human body, with strong concealment, and may not have any symptoms in normal times, but their harm cannot be ignored." Wang Haiyang reminded that after the aorta has expanded to a certain extent, once the blood vessel is "burst", sudden heavy bleeding can cause shock death.
"Abdominal aortic aneurysms are a chronic disease, accounting for about 85% of aortic aneurysms, and there are relatively many middle-aged and elderly men in patients." Professor Wang Haiyang admits that a few decades ago, aortic aneurysms may not be common, but now it has become a relatively common aortic disease in vascular surgery, and hypertension, diabetes, atherosclerosis, cardiovascular and cerebrovascular diseases and smoking are all high-risk factors. Clinically, many patients suddenly rupture aortic aneurysms without any warning, and the mortality rate can be as high as 80%.
Prevention: so away from the aorta "ticking time bomb"
"Clinically, aortic aneurysms and aortic dissection are two common aortic dilation diseases." Wang Haiyang introduced that the aortic wall is composed of the inner membrane, the middle membrane and the outer membrane, and the aortic aneurysm is the uniform expansion of the inner, middle and outer membranes of the arterial wall, expanding outward like a balloon. When the aortic aneurysm swells to the wall of a blood vessel and cannot withstand rupture, it can cause death from shock due to heavy bleeding.
The aortic dissection can also be called aortic dissection aneurysm, is a special type of aortic aneurysm, it is due to the aortic wall lining tear after the opening, high-speed, high-pressure blood flow rushed into the aortic wall between the membrane and the outer membrane, the formation of dissection hematoma, if the aortic wall of the outer membrane is broken by blood flow, resulting in blood vessel rupture, the same can cause patients to bleed heavily, shock death.
"To stay away from the potential risks of aortic aneurysms and aortic dissection, early detection and early intervention are key." Wang Haiyang suggested that people with high risk factors such as hypertension, atherosclerosis, smoking history, family history, and obesity, especially men over the age of 65 with a history of smoking or family history, should have regular chest X-ray examination and aortic ultrasound examination every year. Once the presence of aortic dilation is found, it should be timely to the vascular surgery department for further investigation and diagnosis. If a major aneurysm or inter-aortic wall hematoma is diagnosed, surgery may be temporarily abstained after adequate safety assessment by a specialist, provided that there are no symptoms and no blood supply to other organs is affected. However, strictly controlling blood pressure, avoiding strenuous exercise, and quitting smoking completely, these daily "homework" must be done enough to prevent the progression of the disease. In addition, regular ultrasound or CT angiography should be done according to the doctor's instructions. Once severe chest pain, abdominal pain and other symptoms appear, you should immediately seek medical attention to avoid the risk of rupture of blood vessels.
Wang Haiyang believes that if surgery is unfortunately needed, there is no need to worry too much, and the blood flow can be "diverted" through minimally invasive interventional surgery, so that the aneurysm is not affected by high-pressure blood circulation and "detonated", and the major trauma and complications caused by traditional open surgery can be avoided.
It is worth reminding that patients with aortic aneurysm or aortic dissection should still take the medicine regularly according to the doctor's instructions after surgery and strictly control blood pressure.
Reminder: These arterial vascular lesions should also be watched out for
Wang Haiyang reminded that in addition to the above-mentioned abdominal aortic aneurysm, aortic dissection and other dilated lesions, there are many vascular stenosis lesions that also need special attention, such as carotid artery stenosis, arteriosclerosis occlusion of the lower limbs, diabetic foot, etc. If they are not treated in time, it will also seriously affect the quality of life of patients.
"Many elderly people have intermittent limping, leg pain, not far away, in fact, it is likely that there is a problem with the blood vessels." Professor Wang Haiyang said that people with severe arteriosclerosis occlusion of the lower extremities are at risk of amputation. In addition, there are also some elderly people with obvious bilateral blood pressure differences, unexplained transient dizziness, blurred vision, numbness in one limb, facial numbness and other symptoms, which may be carotid artery stenosis caused by atherosclerosis.
According to Wang Haiyang, at present, for such arterial vascular stenosis lesions, there are more and more treatment methods, and blood vessels can be reconstructed through minimally invasive intervention. In addition to stenting, it can also achieve "stentlessness" through plaque rotary incision technology, reduce or even avoid the implantation rate of stents in human vessels, thereby avoiding complications such as stent rupture, displacement, and thrombosis, and can be repeated many times to fully improve the "validity period" of their own blood vessels, extend the "time window" of stent implantation, and improve the long-term patency rate of arterial vessels.
Medical Guidance/Professor Wang Haiyang, Chief Physician, Department of Vascular Surgery, First Affiliated Hospital of Guangzhou Medical University
Expert Profile:
Director of Vascular Surgery, Doctor of Medicine, Chief Physician, Professor, Doctor of Vascular Surgery, Doctoral Supervisor, Postdoctoral Supervisor, National Committee Member of Vascular Surgeon Branch of Chinese Medical Doctor Association. He has presided over 2 projects of the National Natural Science Foundation of China and published more than 20 professional articles in high-level medical journals at home and abroad.
Professional direction: Good at the diagnosis and treatment of common diseases and diseases of vascular surgery, especially minimally invasive treatment of lower extremity varicose veins, carotid artery stenosis, pulmonary embolism, abdominal aortic aneurysm, Budd-Ga syndrome, visceral vascular disease, lower limb arteriovenous obstruction disease, hemodialysis pathway and other diseases. (All-media reporter Weng Shuxian, correspondents Ru Zhina and Han Wenqing)
Source: Guangzhou Daily