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使用自制钢丝圈套器取出血管内异物。

Retrieval of vascular foreign bodies using a self-made wire snare.

作者信息

Mallmann C V, Wolf K-J, Wacker F K

机构信息

Klinik und Hochschulambulanz für Radiologie und Nuklearmedizin, Charité Universitätsmedizin Berlin, Berlin, Germany.

出版信息

Acta Radiol. 2008 Dec;49(10):1124-8. doi: 10.1080/02841850802454741.

Abstract

BACKGROUND

Foreign bodies in the vascular system have a high potential to cause embolization, perforation, and infection. Therefore, numerous commercially available percutaneous retrieval devices have been developed.

PURPOSE

To evaluate the feasibility and efficacy of a self-made wire snare for the retrieval of foreign bodies in the vascular system.

MATERIAL AND METHODS

16 consecutive patients, who underwent percutaneous foreign-body retrieval between 1997 and 2007, were included in this retrospective analysis. Percutaneous extraction was performed using an adjustable wire snare that was fabricated using a 5F diagnostic Headhunter or Multipurpose catheter and a 4-m-long 0.018-g/inch standard heavy-duty wire that was bent in the middle to create an eccentric loop.

RESULTS

Percutaneous foreign-body retrieval was successful in all 16 cases. Intraluminal materials including partially fractured venous catheters, guidewires, a stent, and a vena cava filter were removed from various locations. In six cases, mobilization of the intraluminal material via a pigtail catheter was necessary before using the wire snare for removal. Successful retrieval was investigator independent. In no cases were surgical procedures required, and no relevant complications were encountered.

CONCLUSION

This snare technique is an effective, feasible, and cost-effective method to retrieve intraluminal material. It is an alternative to commercially available retrieval devices.

摘要

背景

血管系统中的异物极有可能导致栓塞、穿孔和感染。因此,已经研发出了众多市售的经皮取出装置。

目的

评估一种自制钢丝圈套器用于取出血管系统中异物的可行性和有效性。

材料与方法

本回顾性分析纳入了1997年至2007年间接受经皮异物取出术的16例连续患者。使用一种可调节钢丝圈套器进行经皮取出,该圈套器由一根5F诊断性猎头导管或多功能导管以及一根4米长、0.018克/英寸的标准重型钢丝制成,钢丝在中间弯曲形成一个偏心环。

结果

16例患者经皮异物取出均获成功。从不同部位取出了腔内物质,包括部分断裂的静脉导管、导丝、一个支架和一个腔静脉滤器。6例患者在使用钢丝圈套器取出之前,需要通过猪尾导管移动腔内物质。成功取出与术者无关。所有病例均无需进行外科手术,也未出现相关并发症。

结论

这种圈套器技术是一种有效、可行且经济高效的腔内物质取出方法。它是市售取出装置的一种替代方法。

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