导丝成袢技术协助导管通过长段闭塞髂动脉的应用  

Guidewire looping technique assisting catheter in threading long-segment occlusions of iliac artery

作　　者：刘小春[1] 陈伟清[1] 郑国富[1] 谢海亮 叶波[1] 熊吉信[2] 

机构地区：[1]江西省赣州市人民医院普外二科,赣州341000 [2]南昌大学第二附属医院血管外科,南昌330006

出　　处：《江西医药》2016年第6期513-515,共3页Jiangxi Medical Journal

摘　　要：目的探讨导丝成袢协助导管"翻山"通过长段闭塞髂动脉的技术要点和可行性。方法把导丝的"J"形头在闭塞的血管内塑成"U"型袢,顺势将"U"型袢向远端推送,利用"U"型袢的撑张作用,协助导管跟进,逐步进入流出道。结果 11例髂动脉长段闭塞(>10cm)患者中有9例采用了导丝成袢技术,8例导管导丝通过闭塞段进入流出道,技术使用率72.7%,成功率88.9%,未成功1例采用逆穿股动脉协助通过,均未出现血管穿孔严重并发症,2例患者导丝未成袢通过闭塞段。结论导丝成袢协助导管"翻山"通过长段闭塞髂动脉的技术可行,有效,但必须由熟练掌控导管、导丝技术的医师进行操作。Objective To discuss the technical essentials and feasibility of guidewire looping technique in assisting the catheter to “cross over” and pass through long-segment iliac artery occlusion. Methods A U-form loop was formed in the blood vessel at the J-shape end of the guidewire,and was pushed to the distal direction. With support of the U-form loop,the catheter gradually passed to the outflow tract. Results Nine of 11 patients with long-segment iliac artery occlusions （〉10cm） underwent guidewire looping technique assisting the catheter to pass through the occlusive segment. Eight of them entered into the outflow tract successfully. Another one achieved successful retrograde femoral artery catheterization. There were no severe complications including vascular perforation. Technology utilization rate was 72.7% and success rate was 88.9%. The guidewires passed through long-segment occlusions without forming a U loop in left two cases. Conclusion Guidewire looping technique is a feasible and effective method for assisting the catheter to “cross over” and pass through long-segment iliac artery occlusion. However,this technique must be performed by physicians who are skillful at controlling catheters and guidewires.

关 键 词：闭塞性 髂动脉 介入治疗 导丝 

分 类 号：R654.4[医药卫生—外科学]