First Unit of Vascular Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
School of Vascular Surgery, University of Milan, Milan, Italy.
Catheter Cardiovasc Interv. 2020 Apr 1;95(5):971-977. doi: 10.1002/ccd.28380. Epub 2019 Jun 23.
We report a case of a celiac trunk stenting using a steerable guiding catheter, to fix a residual endoleak following fenestrated endovascular repair (FEVAR) of a thoraco-abdominal aortic aneurysm (TAAA). A systematic search of the literature about the use of steerable catheters was also performed on Pubmed according to the PRISMA Guidelines, including all papers in which the device was used for in vivo endovascular procedures. In our case report, the patient had undergone a failed attempt of cannulation due to the presence of a severely angulated and stenosed ostium of the vessel. A steerable catheter was then used to fix the residual endoleak. The search of the Literature retrieved 544 papers. Of them, 13 met the inclusion criteria and were therefore assessed. The use of steerable sheaths and catheters was reported as effective and safe for the cannulation of 157 target vessels in 131 endovascular procedures, with a success rate of 95.5% and no complications. The use of a steerable guiding catheter in our experience was safe and effective for the selective cannulation of a severely stenosed and angulated celiac trunk, to correct a residual endoleak after FEVAR for TAAA. Steerable catheters could be useful tools for the selective cannulation of target vessels with a challenging ostium.
我们报告了一例使用可转向引导导管治疗腹主动脉瘤腔内修复术后残余内漏的病例。根据 PRISMA 指南，我们还在 Pubmed 上对使用可转向导管的文献进行了系统检索，包括所有在体内血管内手术中使用该设备的论文。在我们的病例报告中，由于血管严重迂曲和狭窄，患者曾尝试进行导管插入失败。然后使用可转向导管固定残余内漏。文献检索共检索到 544 篇论文。其中，符合纳入标准的有 13 篇，并进行了评估。在 131 例血管内手术中，157 个靶血管的可转向护套和导管的使用被报道为有效和安全的，成功率为 95.5%，且无并发症。根据我们的经验，在选择性穿刺严重狭窄和迂曲的腹腔干时，使用可转向引导导管是安全有效的，可纠正 TAAA 腔内修复术后的残余内漏。可转向导管可能是用于选择性穿刺具有挑战性的靶血管的有用工具。
