تدريب Shadowing: (English) Acute high grade MCA stenosis PTA and Stenting - تعلم التحدث بالإنجليزية عبر الفيديو
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Hello dear colleagues, my name is Almohamed
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and today we have an acute progressive high -grade stenosis of the left middle cerebral artery
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which we've treated with PDA and standing.
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It was a 90 -year -old patient, female, came from home with a phagia, one point on an IHSS scar. As you can see,
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she has a high -grade stenosis of the M1 segment of
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the left medocerebral artery with a delay on the time to drain in the CT perfusion.
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Initially, the patient was treated only with dual antiplatelet therapy with ticagrelor and aspirin.
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Three days later, the patient has deteriorated and developed a global aphagia with a hemipurrisis,
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five points on the NIHSS score.
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And here we have the follow -up.
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As you can see, she has now a subtotal occlusion of the left medocerebral artery
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with a severe perfusion deficit in almost all the MCA territory on the left side.
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So we've performed an acute mechanical regionalization,
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and here you can see a complete regredience of the middle cerebral artery stenosis and a complete regredience of the perfusion deficit.
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And here we have a list of the materials and devices
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that we've used we've used a PTA Ballon microcatheter NeuroSpeed 2x8 mm
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and a MicroStand Cradle Heal 3x25 mm with an anti -thrombogenic coating.
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And here we go.
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We insert the long sheath NeuronMax with the PenumraSelect catheter into it into the short femoral sheath.
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and now we're moving the angio table to see the aortic arch.
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The penumbra select catheter is already configured and now we're trying to navigate the left common carotid artery.
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Here is it, and now we're pushing the neuromax long sheath a little bit distally,
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And here we make a road map to see the anatomy,
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and now we're pushing the preliminary select catheter into the internal cardoid artery and the long sheath NeurMax.
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We've removed the select catheter because we have reached our first destination, and now we have the intermediate catheter,
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penumbra 5 max, and now we're inserting the intermediate catheter and trying to navigate the distal parts of the internal carotid artery,
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and now we've reached the pituitous segment of the ICA.
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And here we're preparing our projection on A and B,
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And as you can see, we have a high -grade stenosis of the left metacerebral artery in the M1 segment,
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with a very delayed flow in almost the wall MCA territory.
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And now we need a 3D angiogram so
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that we can adjust our projection to see the MCA stenosis a little bit better, and make a plan of our treatment.
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And here we have the 3D angiogram, and as you can see,
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this is the high -grade MCD stenosis, it's a subtotal occlusion.
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And now we will use the 3D angiogram to adjust our projections. And here we go.
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We zoom a little bit and inject contrast medium to see the anatomy.
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And now we can see the stenosis and we will focus on the stenosis.
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And we will take the maximum zoom that we have, and here is the stenosis on our target acquisition.
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And now we take these images and make an overlay of that.
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And here we have the balloon microcatheter NeuroSpeed 2x8 millimeters.
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And now we are preparing the balloon, inserting contrast medium in the hub of the balloon,
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and attaching the syringe to the hub applying a negative pressure on the syringe and knocking on it with our finger
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and now we're attaching the lumen hub of the balloon to saline
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and we activate the hydrophilic coating by wiping it with a wet sheet and now we're waiting for the microwire Synchro 14,
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and that's it.
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And now we insert it in the back of the micro catheter balloon.
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And here we're shaping the tip of the microwire with the shaper,
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we just only need a little curve on the tip of the microwire,
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and now we're inserting the micro -catheter balloon with the micro -wire.
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And now we are starting navigating the distal parts of the left ICA.
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Before we navigate the stenosis, we bring the intermediate catheter a little bit distal is so that we have a very good base,
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and now we are navigating the stenosis, and here we are passing the stenosis,
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and now we are at the distal parts of the M1 segment and 2 segment of the left MCA,
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and now we have a stable position of the microwire and here we're pushing the balloon catheter to reach the stenosis.
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The first distal marker of the balloon catheter is the tip of the micro catheter and the
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following two markers are the markers of the balloon.
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And now we have here the inflator.
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and now we perform the PDA, we go to six bar,
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and here is the balloon.
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We deflate the balloon, as you can see we are a little bit distilled in the stenosis,
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so that we need to pull the balloon a little bit back and re -perform the PDA,
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so that we make sure that we have reached the stenosis.
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And now we pull the micro wire And here we have the microstent Credo heel 3 by 25 millimeters.
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And now we're inserting the microstent in the microcatheter balloon.
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This is the advantage of this microcatheter balloon.
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You don't need to change to other microcatheter you just leave it in place and insert the micro stent,
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and here we have the micro stent.
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I'm trying to put this tent in the wall segment, M1 segment of the left mediacerebral artery,
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because it was dysplastic and hypoplastic along the wall M1 segment.
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And now we're pushing the micro stent a little bit, and pulling the micro catheter balloon backwards,
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and now we have the stent in place.
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We can pull the micro stent pusher with the micro catheter balloon.
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And now we take a round and see our results.
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And as you can see, complete regredients of the MCA stenosis.
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The inferior branch of the MCA was already a little bit delayed
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and we don't want to exaggerate and put another stent in this very small branch.
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On the left side we have the stenosis before treatment, and on the right side after treatment, and it is a very big difference.
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And here we have our overview,
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and as you can see it's a very better blood flow in the MCA territory.
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And here we have on the left side before the treatment and on the right side after treatment,
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it is a very big difference and we can see a lot more branches of the MCA territory.
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And now we've reached the end of our intervention.
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If you have any questions, please put them in the comments below.
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You can contact us per email.
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You can find our email addresses and further contact options in the video description below.
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Thank you for watching.
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See you next time.
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That was Al -Muhammad.
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Peace out.
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Thank you.
تنزيل التطبيق
كل ما تحتاجه للتحدث بطلاقة
تقييم النطق بالذكاء الاصطناعيتقييم كل جملة
تدريب IPAأتقن كل صوت
المفرداتابنِ رصيدك من الكلمات
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لماذا من الضروري ممارسة التحدث مع هذا الفيديو؟
تعتبر ممارسة التحدث باستخدام الفيديو طريقة فعالة لتحسين مهاراتك في "تعلم الإنجليزية عبر الفيديو". الفيديو يتناول موضوعًا طبيًا معقدًا، مما يجعله فرصة رائعة لاستخدام المصطلحات الفنية باللغة الإنجليزية. من خلال الاستماع إلى الحوار، يمكن للمتعلم أن يتعرض لأساليب مختلفة في التعبير عن الأفكار، مما يساعد على تعزيز الثقة في التحدث.
فوائد ممارسة التحدث
- تحسين المفردات: التعرض لمصطلحات جديدة مثل "high-grade stenosis" و"microcatheter" يعزز من فهمك للمجال الطبي.
- زيادة الطلاقة: تكرار العبارات يساعد في تسريع قدرتك على التحدث بطلاقة.
- تطوير النطق: التركيز على كيفية نطق الكلمات بشكل صحيح يعزز من قدرتك على التواصل.
قواعد وعبارات في السياق
تتضمن المحادثة مجموعة من الهياكل المفيدة التي يمكن للمتعلمين استخدامها:
- "We've treated with PTA and stenting": هذه العبارة تعكس استخدام صيغة الماضي البسيط، مما يساعد على تحديد الأحداث بشكل واضح.
- "As you can see": تستخدم هذه العبارة لتوجيه انتباه المتحدث إلى شيء محدد، مما يعزز من مهارات التركيز في المحادثة.
- "She has now a subtotal occlusion": تعكس هذه العبارة استخدام الزمن الحاضر التام، ما يساعد في التعبير عن حالة مستمرة.
يمكنك تطبيق هذه الهياكل في محادثاتك اليومية لتحسين مهاراتك في "تحسين النطق باللغة الإنجليزية".
فخاخ النطق الشائعة
تشمل المحادثة كلمات قد تكون صعبة النطق، مثل:
- "stenosis" - قد يواجه المتعلمون صعوبة في نطق الحرفين "s" و"t" بشكل متتابع.
- "microcatheter" - التركيب الطويل قد يؤدي إلى ارتباك في النطق، لذا من الأفضل تقسيم الكلمة إلى مقاطع.
لتحسين النطق، يوصى بتقنية "shadow speech" أو "shadowspeaks"، حيث تقوم بتقليد نطق المتحدث الأصلي بشكل مباشر بعده، مما يساعدك على ضبط النبرة والتركيز على الأصوات الصحيحة.
القواعد في هذا الفيديو
أكثر التراكيب التي يستخدمها المتحدث، مع العبارات نفسها من الفيديو:
| التركيب | في الفيديو |
|---|---|
| المضارع التام have/has + اسم المفعول — حدث ماضٍ ما زال له أثر الآن | we've treated · has deteriorated · we've performed |
| المبني للمجهول be + اسم المفعول — التركيز على ما يحدث لا على من يفعله | was treated · is already configured |
ما هي تقنية التظليل الصوتي؟
التظليل الصوتي (Shadowing) تقنية تعلم لغة مدعومة علمياً، طُورت أصلاً لتدريب المترجمين الفوريين المحترفين. الطريقة بسيطة لكنها قوية: تستمع لصوت إنجليزي أصلي وتكرره فوراً بصوت عالٍ — كظل يتبع المتحدث بتأخير 1-2 ثانية. تُظهر الأبحاث تحسناً كبيراً في دقة النطق والتنغيم والإيقاع وربط الأصوات والاستماع والطلاقة.