Houdart E, Mounayer C, Chapot R, Saint-Maurice J P, Merland J J
Department of Neuroradiology and Therapeutic Angiography, Hĵpital Lariboisière, Paris, France.
J Endovasc Ther. 2001 Dec;8(6):579-82. doi: 10.1177/152660280100800608.
To present a modification of both the guiding catheter and stent delivery system to facilitate access into sharply curved supra-aortic vessels during carotid angioplasty.
Access failures during carotid interventions typically occur because either the vessel origin is acutely angled or the stenosis is located proximal to the carotid bifurcation, limiting access to the external carotid artery. We directly catheterized the left common carotid artery or brachiocephalic trunk with a guiding catheter whose tip had been curved by steam-shaping. The tip of the stent delivery system also was molded into a curve by this process so it engaged the curved part of the guiding catheter without pulling it out of the vessel.
This simple modification can improve the success rate of carotid cannulation via the femoral approach and does not seem to increase the risk of the intervention.
介绍一种对引导导管和支架输送系统的改良方法，以利于在颈动脉血管成形术期间进入急剧弯曲的主动脉弓上血管。
颈动脉介入治疗期间的穿刺失败通常是因为血管起源处呈锐角或狭窄位于颈动脉分叉近端，限制了进入颈外动脉的通路。我们使用通过蒸汽塑形使其尖端弯曲的引导导管直接插入左颈总动脉或头臂干。支架输送系统的尖端也通过此过程塑形成曲线，使其与引导导管的弯曲部分相契合，而不会将其从血管中拔出。
这种简单的改良可以提高经股动脉途径进行颈动脉插管的成功率，并且似乎不会增加介入治疗的风险。
