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成功治疗主动脉支架置入术中的意外并发症:采用同轴技术取出断裂的支架移植物尖端。

Successful treatment of unexpected complication during aortic stent-grafting: retrieval of broken stent-graft tip by coaxial technique.

机构信息

Departments of Radiology, Ankara Yıldırım Beyazıt University School of Medicine, Ankara, Turkey.

Department of Radiology, Ankara Training and Research Hospital, Ankara, Turkey.

出版信息

Diagn Interv Radiol. 2019 Mar;25(2):169-172. doi: 10.5152/dir.2019.18263.

Abstract

Thoracic aortic endovascular repair (TEVAR) is increasingly preferred as a treatment of choice in thoracic aortic diseases. Intravascular foreign body is one of the TEVAR-related complications similar to the other endovascular operations. Here, to the our best knowledge for the first time in the English literature, this report presents an extremely rare complication of a broken and stuck tip part of aortic stent-graft in the intravascular space and successful removal by using the coaxial technique. Thoracic aortic endovascular repair (TEVAR) has been increasingly preferred as the treatment of choice in thoracic aortic diseases (1). Endovascular treatment has been gaining popularity compared with open surgery due to its less invasive approach and rapid application, and allows the patient to easily return to daily life (2). However, TEVAR is associated with several specific complications including paraplegia, stroke, vascular injuries and local complications. These complications depend on vascular or nonvascular comorbidities, vascular anatomy, equipment, and experience of the provider (3-6). Intravascular foreign body could be among TEVAR-related complications similar to other endovascular operations (7). Several types of equipment, including guidewire, vascular sheath, or suboptimally uncoiled stents may get stuck in the intravascular space, causing complications (8). Herein, to the best of our knowledge, we present the first report in the English literature of broken and stuck tip part of an aortic stent-graft in the intravascular space and its successful removal using the coaxial technique.

摘要

胸主动脉腔内修复术(TEVAR)作为胸主动脉疾病的首选治疗方法越来越受到青睐。血管内异物是 TEVAR 相关并发症之一,与其他血管内手术类似。在此,据我们所知,这是首次在英文文献中报道血管内空间中主动脉支架移植物的尖端部分断裂和卡住,并通过同轴技术成功取出这一极其罕见的并发症。胸主动脉腔内修复术(TEVAR)已越来越多地被视为胸主动脉疾病的首选治疗方法(1)。与开放手术相比,血管内治疗因其微创性和快速应用而越来越受欢迎,并且允许患者轻松恢复日常生活(2)。然而,TEVAR 与几种特定的并发症有关,包括截瘫、中风、血管损伤和局部并发症。这些并发症取决于血管或非血管合并症、血管解剖结构、设备和提供者的经验(3-6)。血管内异物可能是 TEVAR 相关并发症之一,与其他血管内手术类似(7)。多种类型的设备,包括导丝、血管鞘或未充分展开的支架,可能会卡在血管内空间,导致并发症(8)。在此,据我们所知,我们首次在英文文献中报道了血管内空间中主动脉支架移植物的尖端部分断裂和卡住,并通过同轴技术成功取出。

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Retrieval of iatrogenic intravascular foreign bodies.医源性血管内异物取出。
J Vasc Surg. 2013 Jan;57(1):276-81. doi: 10.1016/j.jvs.2012.09.002. Epub 2012 Nov 7.
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Techniques for intravascular foreign body retrieval.血管内异物取出技术。
Cardiovasc Intervent Radiol. 2013 Aug;36(4):888-97. doi: 10.1007/s00270-012-0488-8. Epub 2012 Oct 17.
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Endovascular graft deployment in the false lumen of type B dissection.B型主动脉夹层假腔内的血管内移植物置入
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