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[球囊扩张式血管内假体(支架)的挽救]

[Salvage of balloon expanded vascular endoprostheses (stents)].

作者信息

Zegelmann M, Liermann D, Classen S C, Kollath J, Harth D, Satter P

机构信息

THG-Chirurgie und Radiologie, J.W. Goethe-Universität, Frankfurt am Main.

出版信息

Vasa Suppl. 1991;33:99-100.

PMID:1838646
Abstract

Since 1987 patients have been treated with tantalum stents at our hospital (iliac arteries n:40, femoro/popliteal arterie n:35). Before expanding indication for stent implantation to other more difficult areas and vessel segments, we need to guarantee that a misplaced or not sufficient expanded or only temporary used stent, perhaps after dissections, could be rescued out of the vessel without damage of the vessel wall. Therefore we used cadaveric arteries and a special "retrivel set" To rescue the expanded stent through the introducer sheet without wessel wall damage was possible in all cases (iliac arteries n:5, femoral arteries n:5). In a second attempt, we showed, that even a TEA was possible, using a ringstripper which cut a typical cylinder of the atheriosclerotic vessel wall overpassing and including the stent. In 7 out of ten cases (cadaveric iliac arteries) the retrograde ringstripping-procedure was successful. The other 3 cases required an incision of the vessel with local thrombendarteriectomia. Insofar a stent implantation should not be considered as a contraindication for this surgica treatment else in later history.

摘要

自1987年以来,我院一直使用钽支架治疗患者(髂动脉40例,股/腘动脉35例)。在将支架植入的适应症扩大到其他更困难的区域和血管段之前,我们需要确保在血管夹层后,一个放置不当、扩张不足或仅临时使用的支架能够无损血管壁地从血管中取出。因此,我们使用尸体动脉和一种特殊的“取出套件”,在所有病例(髂动脉5例,股动脉5例)中,都能够通过导入器片无损血管壁地取出扩张后的支架。在第二次尝试中,我们发现,使用环形剥离器,即使进行经皮腔内血管成形术(TEA)也是可行的,该剥离器可切除覆盖并包含支架的动脉粥样硬化血管壁的典型圆柱体。在十分之七的病例(尸体髂动脉)中,逆行环形剥离手术成功。其他3例需要切开血管并进行局部血栓内膜切除术。因此,在后续病程中,支架植入不应被视为这种手术治疗的禁忌证。

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