Famous Among Top Surgeons in the 90s
Chapter 2090: Constraints and Frameworks
"Should we proceed?" the nurse in the operating room asked the doctors.
If they could, they would prepare the tools for aneurysm embolization.
Interventional surgery for aneurysm treatment involves embolization.
Since interventional surgery operates within blood vessels, unlike open cranial surgery which cuts off blood supply to the aneurysm from outside the vessel, the doctors devised another method to eliminate the aneurysm: inserting a microcatheter into the aneurysm cavity and filling it tightly like filling a pit. This way, blood would no longer flow into the pit (aneurysm), expanding the reservoir (aneurysm), and the aneurysm would naturally not rupture (burst).
This method can be said to have a similar principle to open cranial surgery which clamps off the blood supply to the aneurysm, and it reflects the medical thinking process which is akin to engineering - a proper technical task.
Regarding the nurse’s inquiry and the cardiology team’s doubts, the neurosurgeons did not rush to provide an answer.
Whether embolization surgery can be performed definitely doesn’t simply depend on the number of aneurysms.
The advantage of open cranial surgery is that as long as the doctor can find the aneurysm and their hands are agile enough, even very small aneurysms might be dealt with.
As for embolization, as mentioned before, if the tools can’t even enter the vessel diameter, there’s absolutely nothing that can be done. This is a limitation of interventional surgery, and it hasn’t changed.
The most damning feature of aneurysms is that smaller aneurysms have a relatively high chance of bleeding.
An aneurysm with a diameter smaller than 0.5 is considered small, one larger than 0.6 is ordinary, and one larger than 2.5 is a giant aneurysm. A giant aneurysm is obviously very prone to rupture, and embolization poses significant risks.
Besides the size constraint of the aneurysm’s diameter, the neck diameter is another crucial factor determining whether embolization can be performed. This involves a tool called a coil, used by surgeons to fill the aneurysm cavity, which is soft and flexible like a spring and can expand or contract. If the neck is too large, it may be dislodged by blood flow, collapse, and cause the surgery to fail.
This is why most microsurgical operations are chosen over interventional surgery - the strict limitations of neurointerventional surgery are many. Like Fang Ze, neurointerventional surgery is often used as a preliminary path for microsurgical procedures. Pre-surgical interventional examinations can identify the patient’s vascular condition and determine the position and status of each aneurysm, facilitating the best surgical route for open cranial surgery.
With this in mind, Deputy Director Lv initially emphasized to Zhai Yunsheng that Guoxie could also perform interventional surgery checks, and if problems were discovered, the patient could be immediately transferred to the traditional operating room for surgery, which is quite logical.
Deputy Director Lv dialed a number and murmured at the door, evidently thinking, if it’s not feasible then it’s not feasible, move them to the operating room on the third floor. The young doctors’ delays are just a waste of time.
Xie Wanying stood separated by a glass wall, imagining Doctor Song’s deeply conflicted and perplexed feelings inside the operating room.
The patient was a teacher at Doctor Song’s alma mater, Beidu, and Doctor Song definitely wanted to resolve the teacher’s illness with minimal harm. Comparing a craniotomy to an interventional procedure, the side effects and harm to the patient differ significantly.