This miracle doctor just wants to be fired!

After the anesthesia took effect, Zhou Cheng picked up the radial artery puncture needle.

Bring your left index and middle fingers together and press them on the point where the radial artery pulsates most strongly. Secure the blood vessel in place and ensure that your fingers do not obstruct the puncture site.

Hold the puncture needle in your right hand and insert it into the skin at a 45-degree angle, with the needle tip pointing towards the heart, and slowly advance the needle.

His movements were very skilled, his eyes were fixed on the direction of the puncture needle, and he felt the touch of the needle tip to accurately locate the radial artery.

After the puncture needle entered the skin, he slightly adjusted the angle and continued to slowly advance the needle.

When the needle tip pierces the radial artery, bright red blood can be clearly seen spurting out from the end of the needle, and the blood flow pulsation is obvious.

Chen Ming raised an eyebrow slightly.

That puncture speed was too fast!

As the saying goes, everything is difficult at the beginning. In fact, arterial puncture is the first hurdle in the entire coronary angiography procedure.

Many patients with myocardial infarction have low blood pressure, making it difficult to locate arteries and perform punctures.

Many patients also have vasospasm, or very thin blood vessels that are difficult to locate.

Therefore, the key to the success or failure of many surgeries lies in the skill of the first puncture!

Zhou Cheng's puncture skills were clearly already at a very high level!

This made Chen Ming's desire to steal someone else's partner grow stronger and stronger!

……

"Puncture successful, prepare for sheath placement," Zhou Cheng said. He then took the guidewire from the nurse and slowly inserted it into the puncture needle, advancing it along the radial artery.

During the procedure, he observed the DSA machine screen throughout to ensure that the guidewire followed the blood vessel without deviating from its direction, thus avoiding damage to the inner wall of the blood vessel, until the guidewire successfully entered the brachial artery.

After the guidewire was in place, he pulled out the puncture needle and slowly inserted the radial artery-specific vascular sheath along the guidewire into the radial artery, gently adjusting the angle of the sheath during the process.

Ensure the sheath is inserted smoothly, secure the vascular sheath, and confirm that the sheath is in the correct position, without displacement or bleeding. Then connect the three-way stopcock and prepare for angiography.

Meanwhile, Zhou Cheng covered the sheath with sterile gauze to prevent infection.

"Director Chen, the sheath is in place, we can proceed with the angiography," Zhou Cheng said to Chen Ming.

Chen Ming nodded, put aside his own thoughts, walked to the other side of the operating table, and took the angiography catheter handed to him by the nurse.

He connected the angiography catheter to the three-way valve and slowly advanced the angiography catheter.

Guided by the guidewire, he advanced the angiography catheter toward the opening of the coronary artery.

"Zhou Cheng, please adjust the guidewire position and guide the catheter into the opening of the left coronary artery. The catheter path along the radial artery is slightly tortuous, so please be gentle."

"Received." Zhou Cheng immediately focused on operating the guidewire, slowly adjusting its angle and position according to the vascular images displayed on the DSA machine screen.

He precisely guided the angiography catheter smoothly into the opening of the left coronary artery, avoiding the bends in the blood vessel throughout the process to prevent the catheter from getting stuck or damaging the blood vessel.

Throughout the process, the two cooperated very well, without saying a single unnecessary word, yet they were able to accurately understand each other's intentions.

Every movement was perfectly coordinated.

After the angiography catheter was in place, Chen Ming opened the high-pressure injector and slowly injected the contrast agent into the coronary artery. At the same time, he started the DSA machine to perform multi-angle angiography.

A clear image of the coronary arteries immediately appeared on the screen.

There was a significant narrowing in the proximal end of the left anterior descending coronary artery, with the vessel almost completely blocked. This was the culprit that caused the patient's acute myocardial infarction!

In medicine, there is a term called "criminal blood vessels".

There is also mild stenosis in the circumflex branch of the left coronary artery, but it does not require treatment for the time being. The focus is on opening the left anterior descending branch as soon as possible.

"The angiography clearly shows acute occlusion of the proximal left anterior descending artery, which is consistent with the diagnosis of acute extensive anterior wall myocardial infarction. We are preparing to perform balloon dilation and stent implantation."

Chen Ming's eyes were fixed on the screen.

"Zhou Cheng, change the guiding catheter. When passing through the occlusion, pay attention to the force used to advance the guidewire to avoid displacement due to the bend in the blood vessel."

Zhou Cheng immediately followed the instructions, changed the guiding catheter, picked up a microguidewire, carefully inserted it into the angiography catheter, and slowly advanced it, attempting to pass through the occluded blood vessel.

There were a large number of thrombi on the inner wall of the blood vessel at the occlusion site, and the guidewire encountered some resistance when it was advanced.

Zhou Cheng did not rush. Instead, he slowly adjusted the angle of the guidewire, gently applied force, and pushed it forward little by little. At the same time, he closely observed the position of the guidewire on the screen to ensure that the guidewire did not penetrate the blood vessel wall or deviate from the direction of the blood vessel.

"Be careful. There are many blood clots in the occlusion area. Don't use too much force on the guidewire to avoid perforating the blood vessel. Also, the radial artery is a thinner vessel, so you need to be even more careful with the operation," Chen Ming reminded him from the side, his eyes also fixed on the guidewire image on the screen.

"Understood," Zhou Cheng replied, adjusting the pressure slightly as he continued to advance the guidewire.

After several minutes of effort, the microguidewire successfully passed through the occlusion and reached the distal end of the left anterior descending branch. After confirming that the guidewire was in the correct position, Zhou Cheng stopped the operation.

"Director Chen, the guide wire is in place."

Chen Ming nodded, a look of approval on his face: "Not bad, very fast, and the position is very accurate. It's not easy to operate the radial artery route so skillfully. Next, prepare for balloon dilation."

He took the balloon catheter from the nurse and slowly advanced it along the guidewire until the balloon reached the occlusion site.

"Zhou Cheng, please help me secure the guidewire and prevent it from shifting, especially along the radial artery path. Flowing guidewire can easily lead to vascular damage."

Zhou Cheng immediately secured the guidewire with both hands, keeping its position unchanged, while closely observing the screen and providing timely feedback on the guidewire's status.

Chen Ming activated the high-pressure injector and injected contrast agent into the balloon, causing the balloon to slowly expand, compressing the thrombus and the inner wall of the blood vessel at the occlusion site, and expanding the lumen of the blood vessel.

On the screen, it can be clearly seen that the balloon gradually inflates, the occluded blood vessel lumen slowly widens, and the degree of stenosis gradually decreases.

"Control the pressure at 8-10 atm, maintain it for 30 seconds, apply even pressure, and avoid balloon rupture to prevent damage to blood vessels."

Chen Ming said as he operated the machine.

After 30 seconds, Chen Ming stopped injecting the contrast agent, slowly released the pressure inside the balloon, withdrew the balloon slightly, injected the contrast agent again, and observed the vasodilation.

"The dilation effect is good, and the stenosis has been significantly reduced, but there is still residual stenosis, so we are preparing to implant a stent."

At this moment, Zhou Cheng was ready for stent implantation. He took the stent catheter handed to him by the nurse and slowly pushed the stent catheter along the guide wire.

Under Chen Ming's guidance, he avoided the bends in the blood vessel and precisely delivered the stent to the occlusion site, ensuring that the stent covered the entire narrow segment while preventing stent displacement.

"Stent in place, ready to deploy," Zhou Cheng said.

Chen Ming nodded, his eyes fixed on the screen, and said to Zhou Cheng, "You take over the operation. Slowly release the stent, pay attention to its expansion, and don't apply too much pressure to avoid rupture. Also, keep an eye on the blood vessel's course to ensure the stent adheres to the vessel wall. Special attention should be paid to the precision of stent release along the radial artery."

He wanted to test Zhou Cheng's intervention skills, so he specifically entrusted the stent release procedure to Zhou Cheng.

This will not only hone Zhou Cheng's abilities but also test his operational proficiency.