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“双切口单轨”技术,用于经导丝移除Impella CP装置。

The "two-cut monorail" technique, for the over-the-wire removal of the Impella CP device.

作者信息

Miserlis Dimitrios, Tecos Maria E, Garg Nitin, MacTaggart Jason N, Davies Mark G, Pipinos Iraklis I

机构信息

Department of Surgery, University of Texas Health Science Center, San Antonio, Tex.

Department of Surgery, University of Nebraska Medical Center, Omaha, Neb.

出版信息

J Vasc Surg Cases Innov Tech. 2020 Sep 22;6(4):622-625. doi: 10.1016/j.jvscit.2020.09.006. eCollection 2020 Dec.

DOI:10.1016/j.jvscit.2020.09.006
PMID:33163746
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7599379/
Abstract

The Impella is a percutaneously placed intra-arterial flow pump positioned across the aortic valve for circulatory support. A limitation of the Impella is that it lacks a central wire channel, to maintain intra-arterial wire access when removing the device. Open surgical arterial cutdown is needed for the removal of the Impella CP placed emergently, without the use of preclose sutures. This case review describes an alternative removal method for the aforementioned occasions.

摘要

Impella是一种经皮置入的动脉内血流泵,跨过主动脉瓣放置以提供循环支持。Impella的一个局限性在于它没有中心导丝通道,在移除该装置时无法维持动脉内导丝通路。紧急放置的Impella CP移除时,若不使用预置闭合缝线,则需要进行开放手术动脉切开。本病例回顾描述了针对上述情况的另一种移除方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31fd/7599379/dace1e9cd0df/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31fd/7599379/b2a06342644e/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31fd/7599379/a7d45378a96c/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31fd/7599379/7e9c28b1b7c3/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31fd/7599379/dace1e9cd0df/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31fd/7599379/b2a06342644e/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31fd/7599379/a7d45378a96c/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31fd/7599379/7e9c28b1b7c3/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31fd/7599379/dace1e9cd0df/gr4.jpg

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本文引用的文献

1
Single-centre experience with the Impella CP, 5.0 and RP in 109 consecutive patients with profound cardiogenic shock.109 例严重心源性休克患者应用 Impella CP、5.0 和 RP 的单中心经验。
Eur Heart J Acute Cardiovasc Care. 2018 Feb;7(1):53-61. doi: 10.1177/2048872617743194. Epub 2017 Nov 17.
2
Percutaneous removal using Perclose ProGlide closure devices versus surgical removal for weaning after percutaneous cannulation for venoarterial extracorporeal membrane oxygenation.使用Perclose ProGlide闭合装置经皮移除与手术移除用于静脉-动脉体外膜肺氧合经皮插管后撤离体外膜肺氧合的比较
J Vasc Surg. 2016 Apr;63(4):998-1003.e1. doi: 10.1016/j.jvs.2015.10.067. Epub 2016 Jan 26.
3
Percutaneous left-ventricular support with the Impella-2.5-assist device in acute cardiogenic shock: results of the Impella-EUROSHOCK-registry.
经皮左心室辅助Impella-2.5 辅助装置在急性心源性休克中的应用:Impella-EUROSHOCK 注册研究结果。
Circ Heart Fail. 2013 Jan;6(1):23-30. doi: 10.1161/CIRCHEARTFAILURE.112.967224. Epub 2012 Dec 4.