Pratica di Shadowing: (English) Acute high grade MCA stenosis PTA and Stenting - Impara a parlare inglese con i video
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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.
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Prime impressioni: perché questo video è ottimo per l'italiano
Questo video è un'ottima risorsa per chi vuole migliorare la pronuncia e la fluidità in inglese, soprattutto grazie al linguaggio tecnico e alla narrazione dettagliata. La voce del narratore è chiara, con una velocità controllata, il che lo rende perfetto per la tecnica del shadowing in inglese. Ogni passaggio è descritto con precisione, offrendo un mix di vocaboli specifici (come "stenosi", "catetere") e frasi strutturate che aiutano a capire l'ordine delle parole in contesti reali. Inoltre, la natura didattica del video encoura a ripetere e imitare, fondamentale per il shadow speak.
Analizziamo i dettagli: frasi naturali e come usarle
Ecco tre frasi chiave e perché sono efficaci per l'apprendimento:
- "Hello dear colleagues, my name is Almohamed and today we have an acute progressive high-grade stenosis...": Inizia con un saluto formale, seguito da una presentazione chiara. La struttura "today we have..." è tipica per introdurre un caso, utile per le conversazioni professionali. Ripetendola, si impara a organizzare le idee in modo logico.
- "As you can see, she has a high-grade stenosis of the M1 segment...": La frase usa "as you can see" per indirizzare l'attenzione, un'espressione comune in presentazioni. La parola "stenosis" è tecnica ma pronunciata chiaramente, aiutando a familiarizzare con il vocabolario specifico. Il ritmo lento permette di imitare l'intonazione corretta.
- "We insert the long sheath NeuronMax with the PenumraSelect catheter into it...": La struttura "we insert... with..." mostra come combinare azioni e oggetti. Le parole composte (come "long sheath") insegnano a capire il significato tramite il contesto, mentre la ripetizione di verbi azioni (insert, navigate) rafforza la memoria muscolare per la pronuncia.
Una routine di pratica: repeat-and-record per il shadow speech
Per sfruttare al massimo il video, segui questa routine semplice per il shadowing in inglese:
- Guarda il video una volta per capire il contesto generale.
- Riproduci un frammento di 5-10 secondi, poi metti in pausa e ripetilo immediatamente, imitando l'intonazione e la velocità. Usa il shadow speak per sincronizzare la tua voce con quella del narratore.
- Registra te stesso mentre ripeti: ascolta il recording e confrontalo con il video per notare differenze nella pronuncia o nella fluidità.
- Ripeti il processo per ogni sezione, concentrandoti su frasi difficili. Dopo alcuni giorni, prova a riprodurre il video intero senza pausa: questo migliorerà la tua capacità di seguire un discorso continuo.
Imparare l'inglese con i video è un metodo efficace, e con questa routine il shadowspeaks diventerà un esercizio naturale. La chiave è la costanza: anche 10 minuti al giorno ti aiuteranno a migliorare drasticamente la tua pronuncia e la confidenza nel parlare.
La grammatica di questo video
Le strutture che chi parla usa di più, con le parole esatte del video:
| Struttura | Nel video |
|---|---|
| Present perfect have/has + participio passato — un’azione passata che conta ancora adesso | we've treated · has deteriorated · we've performed |
| Forma passiva be + participio passato — conta ciò che accade, non chi lo fa | was treated · is already configured |
Cos'è la tecnica dello Shadowing?
Shadowing è una tecnica di apprendimento delle lingue supportata da studi scientifici, originariamente sviluppata per la formazione dei traduttori professionisti e resa popolare dal poliglotta Dr. Alexander Arguelles. Il metodo è semplice ma potente: ascolti un audio in inglese di madrelingua e lo ripeti immediatamente ad alta voce — come un'ombra che segue il parlante con un ritardo di solo 1–2 secondi. A differenza dell'ascolto passivo o degli esercizi di grammatica, lo shadowing costringe il tuo cervello e i muscoli della bocca a elaborare e riprodurre simultaneamente i modelli di discorso reale. La ricerca dimostra che migliora significativamente la precisione della pronuncia, l'intonazione, il ritmo, il discorso connesso, la comprensione dell'ascolto e la fluidità del parlato — rendendolo uno dei metodi più efficaci per la preparazione alla prova di speaking dell'IELTS e per la comunicazione reale in inglese.