跟读练习: SVINutes: Intracranial Atherosclerotic Disease: Key Considerations for Stenting - 通过视频学习英语口语

加载中...
1
Hello, I am Amir Hassan, and on Zvinitz today we will be talking about intracranial atherosclerotic disease, key considerations for stenting.
2
ICAT is a significant cause of ischemic stroke, responsible for 10% of ischemic strokes in the US and up to 50% in Asia.
3
In South Texas, we have a 20-30% incidence.
4
The disease process, you have a lot of plaque buildup, which leads to stenosis, increasing stroke risk.
5
The key stroke mechanisms include hemodynamic compromise, artery embolism, in-situ thrombosis, and perforator strokes.
6
Current treatment approaches include medical management with anticoagulants, antiplatelets, and or statin therapy.
7
Interventions that include stenting and angioplasty.
8
On cases with hemodynamic compromise, stenting has significant superiority over medical therapy.
9
In a patient with a basilar stenosis, as you see here on the CT correlating CT perfusion, would benefit this patient much more than medical therapy.
10
Versus a perforator stroke alone, as you can see here, this patient would do much better with medical therapy than intracranial stenting.
11
Quick overview of the Sampras trial.
12
There was a significant risk of instant stenosis.
13
There was a significant risk of ischemic strokes
14
and what you had was the medical management arm doing significantly better than the intervention arm
15
and the trial was prematurely terminated then fast forward several years
16
and we have the weave trial
17
and the weave trial results were published in stroke in april 2019
18
and the main findings were
19
if you stuck to the on-label primary analysis findings you had a 2.6 percent event rate of stroke
20
or death within 72 hours versus
21
if you were off-label those patients were collected in a registry
22
and they had up to 23.9 percent risk of stroke or death within 72 hours.
23
One of the lessons learned were adjacent perforators.
24
You had to undersize the balloon in those lesions and your goal was 60 to 80 percent true lumen diameter.
25
Also experience mattered.
26
In studies where the enrollment sites had the experience of treating three cases or on on average 10 cases like in Sampras, you had a much higher event rate.
27
Whereas in Weave, the average interventionist had placed 37 wingspan stents prior to enrollment.
28
Those who had high experience, greater than 50 wingspan stents prior to their first patient enrollment in Weave had a 0% event rate.
29
We have several studies that looked at our initial experience with the Resolute Onyx stent, balloon-mounted stent that is drug-coded, and then we looked at 30-day outcomes,
30
comparing them to the Sampras medical arm patients with propensity score matching, and we had a multi-center study that included other balloon-mounted stents.
31
And what we found was that most of these patients did significantly better if you were on label, meaning you had to treat the patient and wait for seven days,
32
maximize medical management with dual anti-plitotherapy and statin therapy, and And we also found significant decreased restenosis rates,
33
long-term restenosis, compared to the Wingspan study.
34
And here are the publications so you can look at them yourselves.
35
The main points here are your tips and your setup for support based on our experience.
36
And a key point here is patient selection.
37
Patients with severe tortuosity, type 3 arches, an M for a carotid artery,
38
common carotid, those cases probably be much more aggressive with your medical therapy before approaching stenting.
39
In patients that you do select for stenting, we are very aggressive with P2Y12 testing on all patients.
40
If that P2Y12 number is greater than 200, switch the patients to Berlinta 90mg BID.
41
My partner does use 60mg BID and we have not found a significant difference between my patients and his patients.
42
We always use a bolt ballast or a BMX guide catheter.
43
We find that's much more supportive.
44
If treating anterior circulation, you will have a lot of difficulty with the radial approach, so we primarily prefer femoral access.
45
If you're treating lesions proximal to the periclinoid segment of the carotid, Navian 058-115 is the most supportive DAC.
46
If you're treating an MCA lesion, it doesn't cross the periclinoid ophthalmic segments, so a Cat5 or Sophia EX 115 cm is the preferred distal axis catheter.
47
We always use Zoom 14 support wire, that is our preferred O14 wire, Synchro 2 support if you don't have the Zoom 14,
48
or you can use the Aristotle 14 support wire.
49
Regular Synchro 2 and Traxxas just don't have enough support.
50
We highly recommend the Resolute Onyx 2x8 mm device because it can comfortably increase in size to about 3.25 with post-dilatation.
51
And for all our MCA M1 lesions and our mid-bazilar lesions,
52
your perforator-rich teratoids, I don't care if your MCA or your basilar already measures 3-3.5mm, we always use our Resolute Onyx 2x8.
53
Thank you very much and have a great day.

背景与情境

这段视频是关于颅内动脉粥样硬化疾病支架治疗的医学讲座，内容专业且信息密度高。对话中涉及大量医学术语，如“ICAT”“缺血性中风”“支架置入术”等，同时包含临床试验（如Sampras试验、Weave试验）的分析与治疗建议。此类视频适合英语学习者练习专业领域的听力与口语，尤其能提升对复杂句式和学术表达的理解。

日常交流高频短语5则

  • Key considerations：关键考量因素。例：讨论项目时可问“What are the key considerations for this plan?”（这个计划的关键考量因素是什么？）。
  • Prematurely terminated：提前终止。例：“The meeting was prematurely terminated due to technical issues.”（会议因技术问题提前终止。）。
  • On-label：按说明书（使用）。例：“The drug is used on-label for this condition.”（这种药按说明书用于治疗该病症。）。
  • Propensity score matching：倾向评分匹配（医学统计术语）。可在学术讨论中使用。
  • Significant superiority：显著优势。例：“This method shows significant superiority over the old one.”（这种方法比旧方法有显著优势。）。

影子跟读分步指南

针对视频的专业性，影子跟读（shadow speech）可按以下步骤进行：

  1. 预处理：熟悉术语：先列出视频中的医学词汇（如“stenosis”狭窄、“thrombosis”血栓），查阅发音并跟读，确保基础词汇过关。这是雅思口语练习中应对专业话题的重要技巧。
  2. 分片段跟读：将视频按内容分段（如疾病介绍、临床试验、治疗建议），每段20-30秒。播放后立即跟读，重点模仿重音和停顿（如“key stroke mechanisms include / hemodynamic compromise, artery embolism...”），提升英语影子跟读的节奏感。
  3. 关注逻辑连接词：视频中频繁使用“whereas”“versus”“and”等连接词，跟读时注意其语调变化，体会学术表达的严谨性。这对看视频学英语的逻辑理解很有帮助。
  4. 录音对比：录制自己的跟读内容，与原视频对比。重点检查术语发音是否准确、句子流畅度是否接近原音，逐步缩小差距。
  5. 复述练习：完成跟读後，用自己的话复述片段内容，如“Weave试验表明，有经验的医生使用支架的效果更好”。这能强化对内容的理解，同时提升口语表达能力。

通过以上步骤，不仅能提升影子跟读的技巧，还能积累专业英语表达，为雅思口语练习或学术英语应用打下基础。

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。