It’s no wonder that Fisher didn’t pay much attention to Sanqing’s large-diameter artificial blood vessels.
Because McVie is one of the world's largest suppliers of operating room and ICU medical equipment. It was founded in 1838 and has a history of nearly 200 years.
Since it manufactured the world's first electric operating table 90 years ago, it has relied on continuous acquisitions and development to become the absolute king in ventilators, ecmo equipment (heart-lung machines), artificial blood vessels and other fields.
Whether it is ecmo, ventilator, or artificial blood vessel, McVie is in a monopoly position, with 70% of the global market share.
As a veteran surgical instrument giant, it has experienced 200 years of ups and downs and has never seen any storms. Naturally, it did not take Sanqing, a rising star, seriously.
Unlike Terumo, Maico only has the confidence and arrogance of the Germans, and he is convinced that artificial blood vessels, a field he has developed by himself, will never be overtaken by any latecomers.
As for Sakura State Enterprises, they have been stuck in domestic approval for a long time and are in the second echelon. Naturally, they lack confidence and are timid before fighting.
Of course, this is mainly because the media only reported on aortic replacement surgeries, which basically use large-diameter artificial blood vessels with a diameter greater than 10 mm.
The technology of large blood vessels has long been mature and has been widely commercialized, so it is not difficult to achieve in theory.
The main reason why domestic artificial blood vessels have been unable to break through is that upstream polyester materials need to be imported and there is no self-developed material, so it has been stuck.
Moreover, polyester material also has a difficulty, that is, blood vessels can easily become clogged after being used for a long time.
Arterial blood vessels are better. Because they are large enough and patients take anticoagulant drugs for a long time, it often takes a long time for blockage to occur. It is not visible at the beginning. Long-term tests in the patient's body are required to ensure that there are no problems.
In comparison, medium-diameter artificial blood vessels of 6-10 mm are more difficult. This type of blood vessel is generally used to replace venous blood vessels. The blood flow is slower, blood cells and impurities precipitate, causing the intima to thicken, and thrombosis is more likely to occur.
If the artificial blood vessel is blocked by thrombus, it means the failure of the transplant. If the condition is poor, it may even be more dangerous than before the transplant.
Therefore, the selection of materials for artificial blood vessels is crucial, and the application of anticoagulant coatings is also critical.
Therefore, leading companies such as McVie can build high technical barriers and form a monopoly.
As for small-diameter artificial blood vessels below 6 mm, it is still an international problem and there is an urgent need to fill the gap.
It was only through continuous technological improvements that McVie secured its top spot.
But it has not been able to develop artificial blood vessels below 6 mm.
Therefore, as long as Sanqing did not make a breakthrough in this area, Mai Kewei felt that it would not be a problem and it would be difficult to shake his dominant position.
After thinking about this clearly, Fisher stopped worrying and turned his attention to the production capacity of the new factory.
It is useless to think about anything else. The most important thing is to resume supply as soon as possible.
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Kunming City, First People's Hospital, blood purification room.
At 5 o'clock in the afternoon, at the end of the dialysis patients' disembarkation, the medical staff were busy sorting out data and machines.
Suddenly, there were rapid footsteps outside the door, and a 60-year-old man with gray hair walked in hurriedly with the support of his family.
Nurse Xiao Li looked up and suddenly showed surprise. It turned out to be Uncle Liu, an old acquaintance.
Uncle Liu has been a frequent visitor to the dialysis room since last year. Nurse Li was very familiar with him and asked with a smile: "Uncle Liu, what's the matter? Didn't you just finish dialysis in the morning? Why are you back again?"
Before Uncle Liu could speak, the family members next to him started shouting anxiously.
"My dad came home from dialysis at noon. He was fine at first, but he realized something was wrong an hour ago. This internal impotence seemed to have stopped moving. We rushed him to the hospital. What is going on?"
As soon as he finished speaking, Nurse Li's face suddenly became serious, and she quickly came over to check the internal fistula on Uncle Liu's arm.
Internal fistula is the abbreviation of arteriovenous fistula. It is a common and important pathway for maintenance hemodialysis in patients with chronic renal failure. It is the lifeline for patients to survive.
For patients with poor vascular conditions, surgical anastomosis of the arteries and veins of the upper limbs can be performed, and the arteries and adjacent veins of the forearm near the wrist can be sutured together so that arterial blood can flow in the anastomotic veins to form an arteriovenous fistula. .
This can provide sufficient blood for hemodialysis treatment, reduce the chance of infection, not affect daily life, and provide adequate guarantee for dialysis treatment.
Since veins become arterialized and produce tremors and murmurs, both patients and medical staff can intuitively feel the blood flow and monitor their condition.
But now, even with the naked eye, this internal fistula blood vessel has completely lost all vitality, without any movement, and is as silent as a dead thing.
Nurse Li's expression changed and she immediately called the doctor on duty.
The doctor on duty arrived quickly and made a judgment immediately after understanding the situation.
"It should be that the internal impotence is blocked again."
When the patient's family members heard this, their faces suddenly fell and they began to complain endlessly.
"It's blocked again? What's going on?"
"My dad is almost 70 years old. He started dialysis last year and has had four surgeries in the past six months. He has had internal impotence blocked several times. This is already the fourth time."
"Is your technology good enough?"
The doctor on duty comforted: "I understand your feelings very well. Don't worry. The main reason is that the old man is old and weak. His blood vessel condition is poor and it is easy for blockage to occur. Besides, the puncture for dialysis can cause great damage to the blood vessel itself. This There’s nothing we can do about it.”
"Let's focus on the condition first and solve the problem, okay?"
After hearing this, the family members' faces softened a bit. Although they were anxious, they couldn't say anything else.
The doctor on duty got up and made a call: "Director, there is an emergency here to report to you... Well, okay, emergency contingency plan for internal impotence blockage is started, and the thrombolysis team and access doctor are contacted, right? I see."
After hanging up the phone, he picked up a portable color ultrasound and went to the patient's bedside to evaluate the condition of impotence using ultrasound.
When the image of the impotent blood vessel appears on the screen, everything is clearly visible and clear at a glance.
It turned out that 1.5 centimeters away from the opening of the fistula, close to the heart, a small section of thrombus with a length of 2 centimeters appeared, causing the blood flow near the heart to disappear.
"Huh~" the doctor on duty exhaled. He found that the blockage was easy to deal with. As long as the blood clot was cleared in the shortest time, the problem could be solved.
Five minutes later, the director of the urology department and the thrombolysis team arrived together. After an assessment, they proposed a treatment plan.
"The time for thrombosis is still relatively short, so thrombolysis can be tried first."
At this time, the head nurse also arrived and immediately cooperated with the puncture and intravenous thrombolysis of urokinase.
Under ultrasound guidance, the needle tip passes through the internal flaccid blood vessel and is close to the flaccid opening.
With an order, 100,000 units of urokinase directly face the arterial blood and quickly rush to the thrombus site.
"I hope that the action of urokinase, combined with the impact massage of arterial blood flow, can break open the blood clots and create a miracle."
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"This is the pathway of life. We must persevere and let patients get through this difficult time."
The medical staff looked nervous. Some were staring at the ultrasound screen, and some were staring at the impotence blood vessels. They all kept their eyes fixed, praying secretly in their hearts, waiting for a miracle to appear.
However, time passed by minute by minute, and after a long hour, all 100,000 units of urokinase were infused, but there was still no movement in the internal blood vessels.
"There was no tremor on palpation, no murmur on auscultation, and no blood flow at all on ultrasound assessment."
"According to past experience, the thrombus that could be cleared should have been reflected at this time, but it did not."
After the urology director checked again, his face showed disappointment, he shook his head and said.
The already tense hemodialysis room was suddenly enveloped in an atmosphere of disappointment.
Doctors and nurses, you looked at me and I looked at you, not knowing what to say for a moment.
The director looked around and said in a deep voice: "Don't panic, let's continue to discuss the next treatment plan. Considering that the patient has suffered from internal impotence blockage for the fourth time, the reason for the surgical anastomosis is basically ruled out. It should be due to poor blood vessel conditions and poor endothelium. Abnormal function leads to hypercoagulation, causing repeated impotence and blockage.”
"It seems that given the patient's physical condition, he may not be able to establish internal impotence on his own. Even if the surgery is performed again, there is a high possibility that thrombosis will continue to occur and block the internal impotence blood vessels. This is not a long-term solution."
"Then we can only advise the patient to change the plan."
The doctors in consultation nodded one after another and started a heated discussion.
"A stable and reliable vascular access is the basic guarantee for smooth hemodialysis."
"Usually, in this case, a semi-permanent internal jugular vein tube or artificial blood vessel failure is considered."
"The internal jugular vein semi-permanent tube is simple and easy to perform and is a good way to reconstruct the hemodialysis access."
"This won't work. The patient needs long-term dialysis. The semi-permanent internal jugular vein tube is made of polyester and can only be used for a short period of time. It is easy to cause dysfunction over time, and it will be difficult to solve it at that time."
"Artificial blood vessels are not good for internal impotence. They are all products of the older generation. They have various clinical problems, long patency, easy to cause complications, and a high infection rate. They are also very expensive. Patients have to undergo long-term dialysis, which puts a heavy financial burden on them. Heavy is not a good idea either.”
"Autologous vein transplantation is a good method for patients. It has good compatibility, no need to worry about antigens, no high cost of consumables, few complications, and good postoperative recovery. Although the operation is a bit cumbersome, it is the best choice for the patient."
"But I checked the veins of the patient's lower extremities. The blood vessels are much thinner than ordinary people. I'm afraid it won't be possible to treat internal vein insufficiency."
"Hey, what should we do? There seems to be no way to have the best of both worlds."
"There is no way to get the best of both worlds." An idea suddenly appeared in the director of urology's mind and he said thoughtfully.
"What do you think if Sanqing's artificial blood vessels are used for transplantation?"
"They can all be used on the aorta. The diameter must be thick enough and the elasticity is very good. They are all biomaterials and have good compatibility. There is no need to worry about antigenicity."
"Because it is a clinical trial, it can be used for free. I have seen patients who have undergone aortic replacement and their postoperative recovery has been very good. There have been no negative reviews so far."
The doctors' eyes showed surprise, and they immediately started thinking and kept putting forward their own opinions.
"It sounds like a good idea. But I don't know how durable it is. Patients have to get needles every week for dialysis. I don't know if this artificial blood vessel will hold up over time."
"Don't worry about this. It's better than the patient's own blood vessels. The patient's own veins are so brittle."
"I haven't used it for a long time. I don't know what the patency rate is. It won't happen again after a few weeks of use, right?"
"Probably not. It is thicker than veins and elastic enough. If a blood clot occurs, interventional treatment can be performed."
"That's right. This method is indeed feasible."
The director of urology looked at the clock on the wall and saw that two hours had passed since get off work.
From time to time, footsteps could be heard outside. They were the family members waiting outside the door, pacing back and forth anxiously, waiting for the final result.
He coughed lightly and immediately made a decision.
"That's it, just transplant Sanqing's artificial blood vessel for internal impotence surgery."
"I'll explain it to the family members, and you should hurry up and prepare for the operation."
The family members were so anxious that they immediately agreed to the surgical plan as if they were grasping at the last straw.
The director of urology called Sanqing's medical representative again and asked about the model of the artificial blood vessel.
"Sanqing is about 6-8 mm. Is it a medium-diameter artificial blood vessel suitable for arteriovenous insufficiency surgery?"
Because veins are usually transplanted to cause internal insufficiency, the diameter of the blood vessels should not be too thick, but it should not be too thin either, preferably 6-8 mm.
"We can provide blood vessels of any caliber, including those above 6 mm. But if it is used to treat arteriovenous insufficiency, we have a more suitable blood vessel, which is a small-caliber blood vessel of 5 mm."
"You can rest assured that because it is elastic enough and has enhanced toughness, it can be used for long-term dialysis needle punctures, and it also has a self-healing function."
When the director of urology heard this, he was immediately shocked: "What? You still have small-diameter blood vessels of 5 mm? This is awesome. This is an international problem, and you have solved it?"
Then he was overjoyed again: "That's even better. Send me a 5mm artificial blood vessel as soon as possible."
The upper arm veins are inherently thin. If they are too thick, it will be difficult to bury them in the subcutaneous tissue. While retaining the same function, the thinner the better.
"Okay, I'll be there soon."
Half an hour later, the artificial blood vessel arrived.
The operation went smoothly, and everyone was racing against time in order to get the patient to clear the blood clot as soon as possible.
First, the internal deficient blood vessel with thrombosis is removed, and an artificial vein of the same length is transplanted, and then connected with the artery to artificially form a direct pipeline between the arteries and veins in the body.
The purpose of the surgery is to increase the blood flow of superficial veins, facilitate puncture, and facilitate hemodialysis.
Although the 5 mm blood vessel is of small diameter, it is still larger than the 2.5 mm superficial vein. After the transplantation, an obvious bulge was revealed on the patient's arm.
When the last stitch is completed, the surgeon first loosens the venous clamp and then the arterial clamp to completely open the blood flow.
In an instant, everyone's eyes turned to him.
He placed a finger on the protruding vein and paused for three seconds.
"You can feel the obvious tremor in the blood vessels, and the blood flow has finally been restored."
"Fortunately, the operation was successfully completed."
"Look, color Doppler ultrasound has also detected blood flow."
At this point, the road to life opens again!
Everyone smiled in unison and clapped at the same time.
