쉐도잉 연습: (English) Acute high grade MCA stenosis PTA and Stenting - 영상으로 영어 말하기 배우기
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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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실제 의료 현장 시나리오
이 비디오는 뇌혈관 수술 과정을 설명하는 의료 전문가의 대화입니다. 90세 여성 환자의 좌측 중대뇌동맥 협착 치료 과정을 자세히 다루고 있어, 의료 영어뿐만 아니라 전문적인 대화 구조를 배울 수 있는 좋은 기회입니다. 특히 "고도 협착(high-grade stenosis)", "관류 결핍(perfusion deficit)"과 같은 전문 용어와 수술 도구 이름을 들으며, 전문가들이 어떻게 논리적으로 설명하는지 관찰할 수 있습니다.
유용한 구문과 연어
- "acute progressive high-grade stenosis" - 급성 진행성 고도 협착: 의료 분야에서 자주 사용되는 복합 용어로, 증상의 특성을 정확히 표현합니다.
- "dual antiplatelet therapy" - 이중 항혈소판 요법: 약물 치료 관련 연어로, 치료 방식을 설명할 때 필수적입니다.
- "3D angiogram to adjust our projection" - 투영을 조정하기 위한 3D 혈관조영술: 기술적 과정에서 사용되는 구문으로, 목적과 방법을 연결합니다.
- "navigate the distal parts of the internal carotid artery" - 내경동맥 말단부를 탐색하다: 수술 도구 조작을 설명하는 구문으로, 동작과 위치를 명확히 나타냅니다.
당신의 셰도잉 챌린지
이 비디오의 대화를 듣고, shadowing 연습을 해보세요. 먼저 10초씩 멈추며 전문가의 발음과 억양을 따라하세요. 특히 "NeuroSpeed 2x8 mm"와 같은 도구 이름이나 "subtotal occlusion"과 같은 전문 용어의 발음을 정확히 모방해보세요. 이 연습은 IELTS 스피킹에서 요구되는 유창성과 발음 정확도를 높이는 데 도움이 됩니다. 또한, shadowing site에서 유사한 의료 대화를 찾아 연습하면, shadowspeak 기술을 더욱 향상시킬 수 있습니다. 오늘은 5분만 집중해서 연습해보고, 자신의 목소리를 녹음해 발음 차이를 확인해보세요!
이 영상의 문법
화자가 가장 많이 쓰는 문형을 영상 속 실제 표현과 함께 정리했습니다.
| 문형 | 영상 속 표현 |
|---|---|
| 현재완료 have/has + 과거분사 — 과거의 일이 지금도 관련이 있을 때 | we've treated · has deteriorated · we've performed |
| 수동태 be + 과거분사 — 누가 하는지보다 무슨 일이 일어나는지에 초점 | was treated · is already configured |
쉐도잉이란? 영어 실력을 빠르게 키우는 과학적 방법
쉐도잉(Shadowing)은 원래 전문 통역사 훈련을 위해 개발된 언어 학습 기법으로, 다언어 학자인 Dr. Alexander Arguelles에 의해 대중화된 방법입니다. 핵심 원리는 간단하지만 매우 강력합니다: 원어민의 영어를 들으면서 1~2초의 짧은 지연으로 즉시 소리 내어 따라 말하는 것——마치 '그림자(shadow)'처럼 화자를 따라가는 것입니다. 문법 공부나 수동적인 청취와 달리, 쉐도잉은 뇌와 입 근육이 동시에 실시간으로 영어를 처리하고 재현하도록 훈련합니다. 연구에 따르면 이 방법은 발음 정확도, 억양, 리듬, 연음, 청취력, 말하기 유창성을 크게 향상시킵니다. IELTS 스피킹 준비와 자연스러운 영어 소통을 원하는 분들에게 특히 효과적입니다.