Shadowing-Übung: SVINutes: Intracranial Atherosclerotic Disease: Key Considerations for Stenting - Englisch Sprechen Lernen mit Video

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Hello, I am Amir Hassan, and on Zvinitz today we will be talking about intracranial atherosclerotic disease, key considerations for stenting.
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ICAT is a significant cause of ischemic stroke, responsible for 10% of ischemic strokes in the US and up to 50% in Asia.
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In South Texas, we have a 20-30% incidence.
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The disease process, you have a lot of plaque buildup, which leads to stenosis, increasing stroke risk.
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The key stroke mechanisms include hemodynamic compromise, artery embolism, in-situ thrombosis, and perforator strokes.
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Current treatment approaches include medical management with anticoagulants, antiplatelets, and or statin therapy.
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Interventions that include stenting and angioplasty.
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On cases with hemodynamic compromise, stenting has significant superiority over medical therapy.
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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.
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Versus a perforator stroke alone, as you can see here, this patient would do much better with medical therapy than intracranial stenting.
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Quick overview of the Sampras trial.
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There was a significant risk of instant stenosis.
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There was a significant risk of ischemic strokes
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and what you had was the medical management arm doing significantly better than the intervention arm
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and the trial was prematurely terminated then fast forward several years
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and we have the weave trial
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and the weave trial results were published in stroke in april 2019
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and the main findings were
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if you stuck to the on-label primary analysis findings you had a 2.6 percent event rate of stroke
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or death within 72 hours versus
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if you were off-label those patients were collected in a registry
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and they had up to 23.9 percent risk of stroke or death within 72 hours.
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One of the lessons learned were adjacent perforators.
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You had to undersize the balloon in those lesions and your goal was 60 to 80 percent true lumen diameter.
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Also experience mattered.
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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.
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Whereas in Weave, the average interventionist had placed 37 wingspan stents prior to enrollment.
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Those who had high experience, greater than 50 wingspan stents prior to their first patient enrollment in Weave had a 0% event rate.
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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,
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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.
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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,
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maximize medical management with dual anti-plitotherapy and statin therapy, and And we also found significant decreased restenosis rates,
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long-term restenosis, compared to the Wingspan study.
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And here are the publications so you can look at them yourselves.
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The main points here are your tips and your setup for support based on our experience.
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And a key point here is patient selection.
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Patients with severe tortuosity, type 3 arches, an M for a carotid artery,
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common carotid, those cases probably be much more aggressive with your medical therapy before approaching stenting.
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In patients that you do select for stenting, we are very aggressive with P2Y12 testing on all patients.
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If that P2Y12 number is greater than 200, switch the patients to Berlinta 90mg BID.
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My partner does use 60mg BID and we have not found a significant difference between my patients and his patients.
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We always use a bolt ballast or a BMX guide catheter.
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We find that's much more supportive.
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If treating anterior circulation, you will have a lot of difficulty with the radial approach, so we primarily prefer femoral access.
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If you're treating lesions proximal to the periclinoid segment of the carotid, Navian 058-115 is the most supportive DAC.
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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.
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We always use Zoom 14 support wire, that is our preferred O14 wire, Synchro 2 support if you don't have the Zoom 14,
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or you can use the Aristotle 14 support wire.
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Regular Synchro 2 and Traxxas just don't have enough support.
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We highly recommend the Resolute Onyx 2x8 mm device because it can comfortably increase in size to about 3.25 with post-dilatation.
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And for all our MCA M1 lesions and our mid-bazilar lesions,
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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.
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Thank you very much and have a great day.

Warum man mit diesem Video das Sprechen übt?

Dieses Video bietet eine einzigartige Gelegenheit, Englisch in einem fachlichen Kontext zu üben – ideal für diejenigen, die ihre Englische Aussprache verbessern und sich an komplexe Themen gewöhnen wollen. Der Sprecher verwendet klare, strukturierte Sätze, die sich gut fürs shadowspeak eignen: Du kannst seine Rhythmus und Betonung nachahmen, um dein Flüssigkeit zu steigern. Zudem lernst du, fachliche Begriffe (wie "intracranial atherosclerotic disease" oder "stenting") in natürlicher Sprache zu integrieren – ein Plus für berufliche oder akademische Szenarien.

Grammatik & Ausdrücke im Kontext

  • "responsible for 10% of...": Die Präpositionalphrase "responsible for" wird oft verwendet, um Ursachen zu beschreiben. In der Praxis: "Dieser Faktor ist für 30% der Fälle verantwortlich."
  • "versus a perforator stroke alone...": "Versus" (gegenüber) hilft, Vergleiche zu stellen. Nutze es, um Optionen zu kontrastieren: "Medikamentöse Therapie versus chirurgische Intervention."
  • "we have several studies that looked at...": Die Struktur "studies that looked at" ist üblich, um Forschungsergebnisse vorzustellen. Übe es: "Es gibt Studien, die die Wirkung von Übungen auf die Konzentration untersucht haben."

Häufige Aussprachefallen

Einige Wörter im Video können schwierig sein: "intracranial" (in-tra-KRA-ni-al) – achte auf die Betonung auf der dritten Silbe. "atherosclerotic" (ath-ero-skle-RO-tik) – vermeide, die "th" zu "t" zu verändern. Auch "stenting" (STEN-ting) sollte klar ausgesprochen werden, ohne das "t" zu schwächen. Probier es mit shadow speak: Wiederhole den Sprecher langsam, um die Klänge zu internalisieren. So verbessert du nicht nur deine Aussprache, sondern auch dein Verständnis von fachlichem Englisch.

Mit diesem Video kannst du effektiv Englisch sprechen üben – ob für berufliche Zwecke oder einfach, um dein Niveau zu steigern. Nutze die Gelegenheit, die Strukturen und Wörter zu analysieren, und übe das shadowspeaks – du wirst schnell Fortschritte sehen!

Was ist die Shadowing-Technik?

Shadowing ist eine wissenschaftlich fundierte Sprachlerntechnik, die ursprünglich für die professionelle Dolmetscherausbildung entwickelt und durch den Polyglotten Dr. Alexander Arguelles populär gemacht wurde. Die Methode ist einfach aber wirkungsvoll: Du hörst englisches Audio von Muttersprachlern und wiederholst es sofort laut — wie ein Schatten, der dem Sprecher mit nur 1–2 Sekunden Verzögerung folgt. Anders als passives Hören oder Grammatikübungen zwingt Shadowing dein Gehirn und deine Mundmuskulatur, gleichzeitig echte Sprachmuster zu verarbeiten und zu reproduzieren. Studien zeigen, dass es Aussprachegenauigkeit, Intonation, Rhythmus, verbundene Sprache, Hörverständnis und Sprechflüssigkeit signifikant verbessert — was es zu einer der effektivsten Methoden für die IELTS Speaking-Vorbereitung und reale englische Kommunikation macht.