Wacker F, Cholewa D, Waldschmidt J, Wolf K J
Abteilung für Radiologie und Nuklearmedizin, Klinikum Benjamin Franklin der Freien Universität Berlin.
Rofo. 1999 Feb;170(2):225-7.
The use of mini-laparoscopy scissors to remove a central venous catheter inadvertently fixed to the wall of the brachiocephalic vein is described.
During a rethoracotomy in a 15-year-old female patient, a central venous catheter preoperatively introduced in the left subclavian vein was inadvertently trapped by a suture and fixed to the wall of the left brachiocephalic vein. The foreign body was removed by use of a transjugularly introduced venous sheath, a catheter wire snare, and mini-laparoscopy scissors.
The fixed catheter was freed from the wall of the vein under fluoroscopic control with the help of a mini-laparoscopy scissors. Since the intravasal end of the catheter had already been grasped during mobilization with the wire snare it could be completely removed subsequently without any problem.
The percutaneous, intravascular use of mini-laparoscopy instruments may be considered for foreign body removal in special cases.
描述使用微型腹腔镜剪刀移除意外固定于头臂静脉壁的中心静脉导管的情况。
在一名15岁女性患者的再次开胸手术中,术前插入左锁骨下静脉的中心静脉导管意外被缝线缠住并固定于左头臂静脉壁。通过经颈内静脉置入静脉鞘、导管钢丝圈套器和微型腹腔镜剪刀移除异物。
在微型腹腔镜剪刀的帮助下,在透视控制下将固定的导管从静脉壁上松解。由于在用钢丝圈套器移动导管过程中已抓住其血管内端,随后可毫无问题地将其完全移除。
在特殊情况下,可考虑经皮血管内使用微型腹腔镜器械来移除异物。