German Aortic Center, Department of Vascular Medicine, University Heart & Vascular Center Hamburg, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Department of Vascular Surgery, Ludwig-Maximilians-University Hospital Munich, Germany.
J Endovasc Ther. 2020 Apr;27(2):248-251. doi: 10.1177/1526602819900989. Epub 2020 Jan 28.
To describe a bailout technique to stabilize target vessel catheterization in branched endovascular aortic repair. The technique is demonstrated in a 75-year-old patient with a 75-mm symptomatic type III thoracoabdominal aortic aneurysm that was treated with a t-Branch endograft. If a catheter cannot be advanced for exchange to a more stable guidewire after target vessel catheterization, the balloon-anchoring technique can be applied to stabilize the through-the-branch hydrophilic guidewire. Through a femoral access a catheter and hydrophilic wire are passed outside the device into the target vessel and exchanged with a stiff wire; a semicompliant balloon is advanced over the Rosen wire and inflated in the target vessel, stabilizing the through-the-branch hydrophilic wire and facilitating its exchange with a stiff wire over a catheter or advancement of the bridging covered stent directly. The balloon-anchoring technique adds to the spectrum of bailout techniques that can be applied in cases of challenging target vessel access.
描述一种稳定分支血管腔内主动脉修复中靶血管置管的抢救技术。该技术在一位 75 岁的患者中得到了演示，患者患有 75mm 症状性 III 型胸腹主动脉瘤，使用 t-Branch 分支型覆膜支架进行治疗。如果在靶血管置管后无法将导管推进以更换更稳定的导丝，可以应用球囊锚定技术稳定经分支亲水导丝。通过股动脉入路，将导管和亲水导丝穿过支架输送系统进入靶血管，并与硬导丝交换；将半顺应性球囊沿 Rosen 导丝推进并在靶血管中充气，稳定经分支亲水导丝，便于通过导管或直接推进桥接覆盖支架与硬导丝交换。球囊锚定技术增加了在具有挑战性的靶血管入路情况下可应用的抢救技术范围。
