Parodi Juan C, Schönholz Claudio, Ferreira L Mariano, Mendaro Esteban, Ohki Takao
Department of Vascular Surgery, Instituto Cardiovascular de Buenos Aires, Argentina.
J Endovasc Ther. 2002 Feb;9(1):20-4. doi: 10.1177/152660280200900104.
To present a 2-device technique for cerebral protection during carotid stenting of the internal carotid artery (ICA) in patients with high-grade lesions, contralateral occlusion, and/or an aberrant or nonfunctioning circle of Willis.
A reverse flow system (Parodi Anti-Embolism System [PAES]) is first placed with a 260-cm exchange wire in the common carotid artery 3 cm below the carotid bifurcation. Flow reversal is obtained by inflating the balloons in the external and common carotid arteries. Via an external connector, a guidewire and E-Trap filter are delivered to the distal ICA with active suction from a syringe on the PAES catheter. Once the filter is above the stenosis, the reversed flow is discontinued, and the procedure proceeds under cerebral protection with the filter.
The combination of 2 existing cerebral protection devices could, at least in theory, achieve what neither of them could independently. The "seat belt and air bag" approach may represent the ideal means of treating ICA stenoses in patients with a non-functioning circle of Willis.
介绍一种双装置技术，用于在患有高级别病变、对侧闭塞和/或 Willis 环异常或无功能的患者进行颈内动脉（ICA）支架置入术时进行脑保护。
首先使用 260 厘米的交换导丝将逆流系统（Parodi 抗栓塞系统 [PAES]）放置在颈动脉分叉下方 3 厘米处的颈总动脉中。通过对颈外动脉和颈总动脉中的球囊充气来实现血流逆转。通过外部连接器，在 PAES 导管上用注射器主动抽吸将导丝和 E-Trap 过滤器输送至 ICA 远端。一旦过滤器位于狭窄上方，就停止逆流，然后在过滤器的脑保护下进行手术。
至少在理论上，两种现有的脑保护装置的组合可以实现它们各自单独无法实现的效果。“安全带和安全气囊”方法可能是治疗 Willis 环无功能患者的 ICA 狭窄的理想手段。
