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中华临床医师杂志(电子版) ›› 2017, Vol. 11 ›› Issue (12) : 1917 -1920. doi: 10.3877/cma.j.issn.1674-0785.2017.12.001

所属专题: 文献

临床论著

导丝抓捕技术在急性肱动脉损伤介入治疗中的应用
张希全1,(), 葛世堂1, 陈众1, 齐德明2, 窦树彬1   
  1. 1. 255300 淄博,解放军第148医院介入血管科
    2. 255200 淄博,齐鲁医药学院医学影像系
  • 收稿日期:2017-04-10 出版日期:2017-06-15
  • 通信作者: 张希全
  • 基金资助:
    军队后勤科研计划重点项目(CJN14J010)

Application of guidewire capture technique for interventional treatment of acute brachial artery injury

Xiquan Zhang1,(), Shitang Ge1, Zhong Chen1, Deming Qi2, Shubin Dou1   

  1. 1. Endovascular Interventional Diagnosis and Treatment Center, No.148 Hospital of Chinese People′s Liberation Army, Zibo 255300, China
    2. Department of Medical Imaging, Qilu Pharmaceutical College, Zibo 255300, China
  • Received:2017-04-10 Published:2017-06-15
  • Corresponding author: Xiquan Zhang
  • About author:
    Corresponding author: Zhang Xiquan, Email:
引用本文:

张希全, 葛世堂, 陈众, 齐德明, 窦树彬. 导丝抓捕技术在急性肱动脉损伤介入治疗中的应用[J]. 中华临床医师杂志(电子版), 2017, 11(12): 1917-1920.

Xiquan Zhang, Shitang Ge, Zhong Chen, Deming Qi, Shubin Dou. Application of guidewire capture technique for interventional treatment of acute brachial artery injury[J]. Chinese Journal of Clinicians(Electronic Edition), 2017, 11(12): 1917-1920.

目的

探讨导丝抓捕技术在急性肱动脉损伤介入治疗中的应用价值。

方法

2008年1月至2016年10月间解放军第148医院经股动脉脉插管失败的15例急性肱动脉损伤患者,在经股动脉入路行患侧肱动脉插管失败的情况下,采用患侧桡动脉穿刺成功后,将导丝插入肱动脉损伤段,从股动脉引入圈套器,运用导丝抓捕技术将导丝拉出体外建立股桡动脉通道,然后行球囊扩张及支架植入术。

结果

15例患者均采用导丝抓捕技术获得成功,共植入20枚支架(10例植入1枚,5例植入2枚),术中肱动脉血流恢复。15例随访时间6~36个月(中位随访时间18个月)。14例支架内血流通畅或支架腔内狭窄小于30%未予介入干预,1例患者支架腔内狭窄超过50%再次给予球囊扩张治疗,造影显示血流恢复通畅。随访期间无支架移位、内漏、断裂,无截肢现象发生。

结论

导丝抓捕技术可提高急性肱动脉损伤介入治疗成功率。

Objective

To assess the value of guidewire capture technique in interventional therapy of acute brachial artery injury.

Methods

A retrospective analysis was performed on 15 cases of acute brachial artery injury who failed the catheterization of the affected brachial artery via the femoral artery at No. 148 Hospital of Chinese People′s Liberation Army from January 2008 to October 2016. A guide wire was inserted into the injured brachial artery after puncturing the radial artery of the affected side successfully. By using guidewire capture technique, a goose neck snare was introduced through the femoral artery, which was pulled out of the body to establish femoral-radial artery passage. Then, balloon dilatation and stent implantation were performed.

Results

The technique was successful in all the 15 patients. A total of 20 stents were deployed, with only one stent used in ten patients and two stents used in five patients. After stenting, the blood flow of the brachial artery was restored. The patients were followed for 6-36 months (median, 18 months). Stent patency or stent lumen stenosis<30% was achieved in 14 patients (without any interventional therapy); stent lumen stenosis>50% occurred in one patient, and he was treated by balloon dilation, after which the blood flow returned to normal rapidly. During the follow-up period, no stent displacement, leakage, or fracture occurred, and no amputation surgery was required.

Conclusion

Guidewire capture technique can significantly improve the treatment success rate in acute brachial artery injury.

图4 继续造影显示远端尺动脉及桡动脉显影可,血流完全通畅
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