Sotiriadis Charalampos, Hajdu Steven David, Degrauwe Sophie, Barras Heloise, Qanadli Salah Dine
Cardiothoracic and Vascular Unit, Department of Radiology, University Hospital of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
Department of Cardiology, University Hospital of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
Cardiovasc Intervent Radiol. 2016 Aug;39(8):1209-12. doi: 10.1007/s00270-016-1329-y. Epub 2016 Mar 25.
With the increased use of implanted venous access devices (IVADs) for continuous long-term venous access, several techniques such as percutaneous endovascular fibrin sheath removal, have been described, to maintain catheter function. Most standard techniques do not capture the stripped fibrin sheath, which is subsequently released in the pulmonary circulation and may lead to symptomatic pulmonary embolism. The presented case describes an endovascular technique which includes stripping, capture, and removal of fibrin sheath using a novel filter device. A 64-year-old woman presented with IVAD dysfunction. Stripping was performed using a co-axial snare to the filter to capture the fibrin sheath. The captured fragment was subsequently removed for visual and pathological verification. No immediate complication was observed and the patient was discharged the day of the procedure.
随着植入式静脉通路装置（IVADs）越来越多地用于持续长期静脉通路，人们已经描述了多种技术，如经皮血管内纤维蛋白鞘清除术，以维持导管功能。大多数标准技术无法捕获被剥离的纤维蛋白鞘，这些鞘随后会在肺循环中释放，可能导致有症状的肺栓塞。本病例介绍了一种血管内技术，该技术包括使用一种新型过滤装置剥离、捕获和去除纤维蛋白鞘。一名64岁女性出现IVAD功能障碍。使用同轴圈套器将过滤器套在纤维蛋白鞘上进行剥离，以捕获纤维蛋白鞘。随后取出捕获的碎片进行肉眼和病理验证。未观察到即时并发症，患者在手术当天出院。
