摘要
目的探讨在髂动脉闭塞症中使用鹅颈套圈配合0.035英寸泥鳅导丝行内膜下血管成形术的可行性及适用条件。方法 2011年10月—2013年5月收治一侧髂动脉完全闭塞患者3例,从对侧股动脉入路顺行导丝进入髂动脉内膜下无法返回真腔,再从患侧股动脉逆行穿刺送入导丝,导管与导丝无法在内膜下对吻,遂用鹅颈套圈于内膜下套住导丝建立轨道,完成血管内成形术。结果 3例患者均成功且安全的完成球囊扩张及支架植入术,患者未诉特殊不适。结论髂动脉闭塞症患者在进行内膜下血管成形术时,如导丝无法返回真腔,可考虑在内膜下使用鹅颈套圈配合逆向导丝建立轨道完成血管成形术,但需轻柔操作,注意血管破裂风险。
Objective To study the feasibility of using gooseneck snare combined with 0.035 inch loach guidewire for subintimal angioplasty in iliac artery occlusion , and to discuss its clinical indications. Methods During the period from October 2011 to May 2013, 3 cases with unilateral complete iliac artery occlusion were admitted to authors’ hospital. As the guidewire inserted from the healthy side could not returned into the true lumen once it entered into the subintimal space of the iliac artery , the puncture at the diseased side was carried out and the guidewire was pushed into the artery , but the catheter and the guidewire could not converge or anastomose in the subintimal site , gooseneck snare had to be used to grab the guidewire in subintimal site as to establish a path and completed the angioplasty. Results Successful and safe balloon dilatation and stent implantation were accomplished in all the 3 patients , and the patients complained of no special discomfort. Conclusion In performing the subintimal angioplasty for patients with iliac artery occlusion, the use of gooseneck snare combined with retrograde insertion of guidewire should be considered when it occurs that the guidewire can not return into the true lumen after it enters into the subintimal space. Nevertheless, gentle manipulation is first important in order to avoid the possible rupture of vessels.
出处
《介入放射学杂志》
CSCD
北大核心
2014年第9期802-805,共4页
Journal of Interventional Radiology
