Dregelid Einar
Department of Vascular Surgery, Haukeland University Hospital, Jonas Lies vei 65, 5021 Bergen, Norway.
Int J Biomater. 2012;2012:152845. doi: 10.1155/2012/152845. Epub 2012 Jul 25.
During vascular surgical operations, there is a need for a simpler and more reliable method of temporary arterial occlusion than those currently employed, especially of heavily calcified arteries. A thermosensitive polymer, LeGoo (LG) (Pluromed, Woburn, MA), has been used successfully for temporary vascular occlusion. It has hitherto been injected by a cannula that has been introduced into the artery to be occluded, here henceforth called the "cannulation method." Injection into arterial ostia without cannulation, using an injection device that arrests blood flow during the injection, here henceforth called "a retrograde method" may enable temporary hemostasis when ostial stenoses render it impossible to inject LG using the cannulation method. The objective of the present study was to study the feasibility of a retrograde method and to compare it with the cannulation method in an in vitro model, incorporating a narrow orifice to simulate ostial stenosis, using tap water at 37°C instead of blood. The retrograde method of LG injection, using a modified paediatric Foley catheter, turned out to be feasible to produce a durable LG plug more reliably, at higher water pressure and with less deep LG injection than with the cannulation method.
在血管外科手术中，需要一种比目前使用的方法更简单、更可靠的临时动脉闭塞方法，尤其是对于严重钙化的动脉。一种热敏聚合物LeGoo（LG）（Pluromed，沃本，马萨诸塞州）已成功用于临时血管闭塞。迄今为止，它是通过插入要闭塞的动脉的套管进行注射的，此后在此称为“插管法”。在不插管的情况下将其注入动脉开口，使用一种在注射过程中阻止血流的注射装置，此后在此称为“逆行法”，当开口狭窄使得无法使用插管法注射LG时，这种方法可能实现临时止血。本研究的目的是研究逆行法的可行性，并在体外模型中，采用窄孔模拟开口狭窄，使用37°C的自来水而非血液，将其与插管法进行比较。结果表明，使用改良的小儿Foley导管进行LG注射的逆行法比插管法更可行，能够在更高的水压下更可靠地产生持久的LG栓塞，且LG注射深度更小。
