Практика Shadowing: (English) Acute high grade MCA stenosis PTA and Stenting - Изучайте разговорный английский по видео
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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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Сценарий: Операция по лечению стеноза мозговой артерии
В видео врачи обсуждают акутный случай лечения 90-летней пациентки с высокой степенью стеноза средней мозговой артерии. Диалог полон медицинской терминологии, но его структура проста: описание состояния пациента, этапы процедуры, использование инструментов. Это реальная ситуация, где важно ясно и точно передавать информацию — идеальный материал для практики разговорного английского, особенно для тех, кто интересуется медицинской сферой.
Полезные выражения и словосочетания
- High-grade stenosis — высокая степень стеноза (часто используется в медицине)
- Dual antiplatelet therapy — двойная антиагрегантная терапия (ключевое словосочетание для описания лечения)
- Perfusion deficit — перфузионный дефицит (характеризует нарушение кровотока)
- Navigate the artery — проникать в артерию (описание манипуляций с катетером)
- 3D angiogram — 3D-ангиограмма (визуализационный метод)
Эти фразы не только помогут понять медицинский контент, но и улучшат навык восприятия специализированной речи — важный навык для shadowing английского.
Ваше задание: Shadowing Challenge
Выберите отрезок видео длиной 30 секунд (например, описание этапов вставки катетера). Включите запись, слушайте фразу, затем повторяйте её сразу же, копируя интонацию и темп. Сделайте это 5 раз подряд. Затем попробуйте записать себя и сравнить с оригиналом. Это отличная практика для shadow speak — она помогает улучшить речевую автоматизацию и понимание быстрой речи. Для лучшего результата используйте shadowing site, где можно найти аналогичные материалы с медленной и нормальной скоростью.
Помните: shadowing — это не просто повторение, а погружение в речь. Постепенно вы заметите, как ваше произношение и понимание английского становятся более естественными!
Грамматика в этом видео
Конструкции, которые говорящий использует чаще всего, с точными словами из видео:
| Конструкция | В видео |
|---|---|
| Present Perfect have/has + причастие прошедшего времени — прошлое действие, важное сейчас | we've treated · has deteriorated · we've performed |
| Пассивный залог be + причастие прошедшего времени — важно, что происходит, а не кто это делает | was treated · is already configured |
Что такое техника Shadowing?
Shadowing — это научно обоснованная техника изучения языка, изначально разработанная для подготовки профессиональных переводчиков и популяризированная полиглотом доктором Александром Аргуэльесом. Метод прост, но эффективен: вы слушаете аудио на английском от носителей языка и немедленно повторяете вслух — как тень, следующая за говорящим с задержкой в 1–2 секунды. В отличие от пассивного прослушивания или грамматических упражнений, Shadowing заставляет мозг и мышцы рта одновременно обрабатывать и воспроизводить реальные речевые паттерны. Исследования показывают, что это значительно улучшает точность произношения, интонацию, ритм, связную речь, понимание на слух и беглость речи — что делает его одним из самых эффективных методов для подготовки к IELTS Speaking и реального общения на английском.