St. Joseph Heart and Vascular Center , Orange, CA, USA.
Expert Rev Med Devices. 2020 Sep;17(9):937-944. doi: 10.1080/17434440.2020.1825938. Epub 2020 Oct 3.
The development of thoracic central venous obstruction (TCVO) leads to narrowing of the vessel lumen which impacts blood flow and the placement of central venous access. The most common cause of TCVO is central venous catheters (CVCs) which can induce intravascular scarring or endoluminal obstruction via thrombus formation.
The Surfacer® System is used to obtain central venous access (CVA) in patients with TCVO by facilitating catheter insertion via the novel Inside-Out® approach. This review summarizes the results of clinical studies to date with the Surfacer System, focusing on how the procedure is performed, clinical efficacy and safety of the device and patient populations where the device offers substantial clinical benefit.
The Surfacer System offers a safe and effective approach to reliably preserve and restore critical upper body vascular access sites. For dialysis patients, the device offers an alternative which avoids placement of dialysis catheters in veins which may impact the ability to achieve maturation of hemodialysis vascular access or in locations which have an increased risk of insertion-related complications or are associated with higher morbidity.
胸内中心静脉阻塞(TCVO)的发展导致血管腔变窄,从而影响血流和中心静脉通路的置管。TCVO 最常见的原因是中心静脉导管(CVC),它可通过血栓形成导致血管内瘢痕形成或管腔内阻塞。
Surfacer®系统通过新颖的内外置管方法促进导管插入,用于治疗 TCVO 患者的中心静脉通路(CVA)。这篇综述总结了迄今为止 Surfacer 系统的临床研究结果,重点介绍了该手术的操作流程、设备的临床疗效和安全性,以及该设备能为患者带来显著临床获益的人群。
Surfacer 系统提供了一种安全有效的方法,可可靠地保留和恢复关键的上半身血管通路部位。对于透析患者,该设备提供了一种替代方法,避免将透析导管放置在可能影响血液透析血管通路成熟能力的静脉中,或放置在具有更高插入相关并发症风险或与更高发病率相关的位置。