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血管内技术和程序,血管内异物清除方法。

Endovascular techniques and procedures, methods for removal of intravascular foreign bodies.

作者信息

Motta Leal Filho Joaquim Maurício da, Carnevale Francisco Cesar, Nasser Felipe, Santos Aline Cristine Barbosa, Sousa Junior Wilson de Oliveira, Zurstrassen Charles Edouard, Affonso Breno Boueri, Moreira Airton Mota

机构信息

Sociedade Brasileira de Radiologia Intervencionista e Cirurgia Endovascular, ICHC-FMUSP/InCor/ICESP.

出版信息

Rev Bras Cir Cardiovasc. 2010 Apr-Jun;25(2):202-8. doi: 10.1590/s0102-76382010000200012.

Abstract

INTRODUCTION

The incidence of intravascular embolization of venous catheters reported in the world medical literature corresponds to 1% of all the described complications. However, its mortality rate may vary between 24 to 60%. Catheter malfunction is the most likely signal of embolization, since patients are usually asymptomatic.

OBJECTIVE

To report the method of removing intravascular foreign bodies, catheters with the use of various endovascular techniques and procedures.

METHODS

This is a two-year retrospective study of 12 patients: seven women and five men. The average age was 29 years (ranging from two months to 65 years).

RESULTS

Technical performance was 100% successful. Ten port-a-caths, one intra-cath and one PICC were extracted. The most common sites for the lodging of one of the ends of the intravascular foreign bodies were the right atrium (41.6%) and the right ventricle (33.3%). In 100% of the cases, only one venous access was used for extraction of foreign bodies, and in 91.6% of the cases (11 catheters) the femoral access was used. The loop-snare was used in 10 cases (83.3%). The most common cause of intravascular foreign body insertion was a catheter fracture, which occurred in 66.6% of the cases (eight cases). One major complication, the atrial fibrillation, occurred (8.3%), which was related to the intravascular foreign body extraction. The mortality rate in 30 days was zero.

CONCLUSION

Percutaneous retrieval of intravascular foreign bodies is considered gold standard treatment because it is a minimally invasive, relatively simple, safe procedure, with low complication rates compared to conventional surgical treatment.

摘要

引言

世界医学文献报道的静脉导管血管内栓塞发生率占所有描述并发症的1%。然而,其死亡率可能在24%至60%之间。导管故障是栓塞最可能的信号,因为患者通常无症状。

目的

报告使用各种血管内技术和程序清除血管内异物(导管)的方法。

方法

这是一项对12例患者进行的为期两年的回顾性研究,其中7名女性和5名男性。平均年龄为29岁(范围从2个月至65岁)。

结果

技术操作成功率为100%。取出了10个植入式静脉输液港、1个中心静脉导管和1个经外周静脉穿刺中心静脉置管。血管内异物一端最常见的滞留部位是右心房(41.6%)和右心室(33.3%)。100%的病例中,仅使用一个静脉通路取出异物,91.6%的病例(11根导管)使用股静脉通路。10例(83.3%)使用圈套器。血管内异物置入最常见的原因是导管断裂,66.6%的病例(8例)发生导管断裂。发生了1例主要并发症,即心房颤动(8.3%),与血管内异物取出有关。30天内死亡率为零。

结论

经皮取出血管内异物被认为是金标准治疗方法,因为它是一种微创、相对简单、安全的手术,与传统手术治疗相比并发症发生率低。

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