跟读练习: 12. Parallel Stent Retriever Technique in Mechanical Thrombectomy for Acute Ischemic Stroke - 通过视频学习英语口语
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I'm Dr. Asim Javed.
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I'm an international cardiologist working at Rawalpindi Institute of Cardiology in Pakistan.
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This is a series of talks to facilitate learning process for performing mechanical thrombectomies in acute ischemic stroke.
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Let's now discuss a bailout parallel strength strategy.
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This is a 58 year old gentleman with left ICR terminus
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occlusion two solumbra attempts had already failed having ruled out icad
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and considering this to be an embolic thing now is a good time to do the parallel stent technique in
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which in this case we wired acf first
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and then we took a tip injection in aca a1 segment to confirm
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that we are in the right place then we wire mcm1 confirm the wire position
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and mcm1 and place our micro catheter there so now
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that both the micro catheters are in place we deployed the first stent retriever in mca
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and then removed its micro catheter then we deployed the second micro catheter in aca
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and removed its micro catheter as well so we removed both the micro catheters
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and now we've got both stent retrievers deployed
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and we have the bare wires coming out and we are holding both the bare wires.
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And then the next thing we did was we removed both we removed both stent retrievers together and pulled out everything.
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But unfortunately we still could not establish flow.
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So what we could have done different was to use double
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-save technique whereby after deploying both stent retrievers the two ray bars are removed the micro catheters
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and then the aspiration catheter slides over the wires of the two stent retrievers
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and then both stents are pulled out simultaneously while doing suction through the aspiration catheter as well.
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So that gives you maximum success
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and in fact you can even have a balloon tip guide at that point and the balloon is also inflated.
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So that will increase maximum chances of success and reduce the chances of distal embolization.
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So this is exactly what is shown in this picture in a systematic way
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that first thing you do is you deploy the two micro
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catheters in the two arteries where you want them you never deploy one stent first
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and then try to wire the second artery your wire is not going to cross through the stent retriever
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and even if it crosses through the second stent retriever will entangle into the first stent retriever
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so you always wire first artery then you place your micro catheter in
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that artery then you remove the same wire
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and you do not deploy the stent at this point in time you take this wire
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and place it into the second artery
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and then you park your micro catheter in the second artery
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once both micro catheters are in place then you can bring
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in your stent retriever in any of these micro catheters deploy
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the first stent retriever then deploy the second stent retriever then remove both the micro catheters
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and the bare wires
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that are coming out of the guide catheter now you need to take them out of your wire connector simultaneously
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and then on top of these two wires you bring in your respiration catheter
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which could be SOFIA or REACT
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and then you take it right all the way to the clot
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and once it starts it once it hugs the clot that's the time you start your aspiration
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so now you are doing sort of solumbra with two stent retrievers
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and one aspiration catheter so this is the double safe technique and
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if you have a balloon tip guide you also deploy the
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inflate the balloon of the balloon tip guide at this point
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and then you pull out everything and you get the maximum chances of success
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so this is the parallel stent technique Why you need to remove the two micro catheters
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and you can't take aspiration catheter from the beginning because the two micro catheters cannot go simultaneously through the aspiration catheter.
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So we have to most likely deploy both the stent retrievers
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and micro catheters through the guide catheter and not through the aspiration catheter
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so this is a 45 year old lady with four hours
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history of left -sided hemiplegia patient had left ICA critical disease
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which was non -culprit but was cross -filling right ACA right common carotid artery was totally occluded
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so basically this was a case of acute on chronic total
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occlusion of right common carotid artery six French 90 centimeter guide sheath six French aspiration catheter and Raybar micro catheter was taken.
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Traxxas wire could not cross.
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Pilot 200 and Gaia CTO wires could not cross the occlusion as well.
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Hornet 14 wire was able to cross the occlusion with the help of Caraval micro catheter.
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Check injection through Caraval micro catheter tip was done to confirm true lumen.
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Sophia plus 6 French failed to cross the proximal occlusion site.
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So we plan to do POBA in presence of distal protection filter.
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7 mm spider FX filter was deployed in right internal kerotid artery
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and then right ICA osteoballooning was done with 4 .5 by 15 mm NC tract balloon.
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Post ballooning there was no flow in the kerotid.
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6 French aspiration catheter for aspiration was used for aspiration up to the spider effects.
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So we thought there was no reflow because of the spider effects blockage.
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But it could not establish flow.
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So then trexus wire was brought back into the internal carotid artery and spider effects was removed.
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Again aspiration was done with SOFIA plus
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and this time flow was established in ICA but ICA terminus occlusion was found to be occluded.
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but one minute later the carotid flow also stopped again.
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This time we decided to deal with austere ICA first and deployed carotid wall stent 7 by 30 millimeters.
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Then we went on to deal with ICA terminus occlusion
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and performed Solumbra with SOFIA plus and Solitaire X 4 by 40 millimeters
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but after three attempts of Solumbra ICA terminus still remain occluded.
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We decided to go with parallel stent technique.
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Right ACA could not be wired and was cross -filled from left ACA.
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So we placed both wires in superior and inferior deviance of MCA.
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Two Raybar microcatheters were placed in both MCA deviance.
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Two stent retriever solitaire X 4x40 mm were deployed in ICA terminus starting from proximal segments of M2 deviance.
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Both rebars were removed and SOFIA plus was brought in and then the whole assembly was removed as one unit.
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right ICA and MCA were re -canalyzed
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and right ACA was cross -filled through ACOM right ICA stent was also patent
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and this is our neurologist examining the patient two hours later in the ward
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and the other side is the bagu, the bagu
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and the bagu is the bagu and the bagu is the bagu
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and the bagu is the bagu and the bagu is the bagu and the bagu is the bagu
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This is the case of basilar reclution One attempt of ADAPT
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and two attempts of Sulembra failed to re -canalyze basilar artery
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We decided to go with parallel stent technique You can see wire going into left PCA across the distal basilar occlusion.
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Ribber was parked in left PCA and then second wire and micro catheter were taken into the right PCA.
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Now you can see two stent retrievers 4x40 mm deployed in both PCAs
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and SOFIA plus aspiration catheter in place just hugging the clot.
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Both stent retrievers and SOFIA were removed as one unit and this is a comparison of pre and post intervention DSA images.
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This is again pictorial representation of the parallel stent technique and now this is the patient 48 hours later.
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Take.
FOR YOU
推荐视频
本课的词汇与口语要点
这段视频共有 99 个句子、1275 个单词可供跟读。 讲话部分时长为 9:24。 说话人语速平稳,每分钟约 136 个词,很适合跟读。 只有 70% 的单词属于英语最常用的 3,000 词,词汇难度较高。
视频中的重点词汇
视频中 15 个值得学习的单词,附发音和释义:
| 单词 | 发音 | 释义 |
|---|---|---|
| wire 名词 | /ˈwaɪɚ/ | 線 /线, 鐵絲 /铁丝 |
| microwave 名词 | /ˈmaɪkɹoʊˌweɪv/ | 微波 |
| deploy 动词 | /dɪˈplɔɪ/ | 部署 |
| artery 名词 | /ˈɑɹ.təɹ.i/ | 動脈 /动脉 |
| technique 名词 | /tɛkˈniːk/ | 技術 /技术, 技巧 |
| balloon 名词 | /bəˈlun/ | 氣球 /气球 |
| parallel 形容词 | /ˈpæ.ɹəˌlɛl/ | 平行的 |
| spider 名词 | /ˈspaɪ̯dɚ/ | җўҗў, зузу |
| establish 动词 | /ɪˈstæb.lɪʃ/ | 確定 /确定 |
| confirm 动词 | /kənˈfɝm/ | 證實 /证实, 確認 /确认 |
| simultaneously 副词 | /ˌsaɪmlˈteɪnɪəsli/ | 同時地 /同时地 |
| filter 名词 | /ˈfɪltɚ/ | 過濾器 /过滤器, 濾過器 /滤过器 |
| segment 名词 | /ˈsɛɡmɛnt/ | 片斷 /片断, 段 |
| hug 动词 | /hʌɡ/ | 擁抱 /拥抱 |
| acute 形容词 | /əˈkjut/ | 激烈, 敏銳 /敏锐 |
视频中出现的短语动词
| 单词 | 发音 | 释义 |
|---|---|---|
| come out 动词 | /ˌkʌm ˈaʊt/ | 出, 出來 /出来 |
| rule out 动词 | 排除 |
需要注意的发音
说话人用了 4 次缩略和弱读形式,例如 I'm, can't, we've。请按听到的简短形式来说。
- “th” 音: catheter /ˈkæθɪtɚ/, sheath /ʃiθ/
- “sh” 和 “zh” 音: establish /ɪˈstæb.lɪʃ/, injection /ɪnˈd͡ʒɛk.ʃən/, representation /ˌɹɛp.ɹə.zɛnˈteɪ.ʃən/, intervention /ɪntɚˈvɛnʃən/, aspiration /ˌæspəˈɹeɪʃən/
- 长单词——注意重音位置: simultaneously /ˌsaɪmlˈteɪnɪəsli/, superior /sʊˈpɪɹ.i.ɚ/, representation /ˌɹɛp.ɹə.zɛnˈteɪ.ʃən/, mechanical /məˈkænəkəl/, intervention /ɪntɚˈvɛnʃən/
如何用这段视频练习
- 先完整听一遍视频,不要开口,记下不认识的单词。
- 用正常速度逐句跟读,每句重复到你的节奏与说话人一致为止。
- 录下自己的声音并与原声对比,特别注意 wire, microwave, deploy 这类单词。
什么是跟读法?
跟读法 (Shadowing) 是一种有科学依据的语言学习技巧,最初开发用于专业口译员的培训,并由多语言者Alexander Arguelles博士普及。这个方法简单而强大:您在听英语母语原声的同时立即大声重复——就像是一个延迟1-2秒紧跟说话者的影子。与被动听力或语法练习不同,跟读法强迫您的大脑和口腔肌肉同时处理并模仿真实的讲话模式。研究表明它能显着提高发音准确性,语调,节奏,连读,听力理解和口语流利度——使其成为雅思口语备考和真实英语交流最有效的方法之一。












