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血管内手术中不可扩张球囊引导导管（BGC）：挽救策略。

Undeflatable balloon guide catheter (BGC) during endovascular procedure: Rescue strategy.

作者信息

Lee Hyungkyu, Park Taejoon, Baek Jinwook, Kim Seonghwan, Lee Sangpyung, Ryou Kyoungsoo

机构信息

Department of Neurosurgery, Cheju Halla General Hospital, Jeju, Korea.

出版信息

J Cerebrovasc Endovasc Neurosurg. 2022 Dec;24(4):372-379. doi: 10.7461/jcen.2022.E2021.10.005. Epub 2022 Jul 7.

DOI:10.7461/jcen.2022.E2021.10.005
PMID:35794749
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9829560/
Abstract

The use of a balloon guide catheter (BGC) in the endovascular management of acute ischemic stroke is known to improve the efficacy and efficiency of the procedure by reducing the risk of distal embolization. During the procedure, the balloon of the catheter causes a temporary arrest of cerebral blood flow. However, failure of the balloon to deflate during the BGC procedure can result in catastrophic complications, including aggravated hypoxic damage.
This paper aims to share the resolution and methodological analysis of our experience with BGC balloon deflation failure, which was confirmed by a reproducible experiment under similar conditions.

摘要

在急性缺血性卒中的血管内治疗中，使用球囊引导导管（BGC）可通过降低远端栓塞风险来提高手术的疗效和效率。在手术过程中，导管的球囊会导致脑血流暂时停止。然而，在BGC手术过程中球囊无法放气可能会导致灾难性并发症，包括加重缺氧损伤。本文旨在分享我们处理BGC球囊放气失败的方法及经验分析，这一过程通过在相似条件下可重复的实验得到了证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a723/9829560/5c3c328e4bf5/jcen-2022-e2021-10-005f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a723/9829560/375548c69b66/jcen-2022-e2021-10-005f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a723/9829560/85f8da7dc9ff/jcen-2022-e2021-10-005f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a723/9829560/e2790befc594/jcen-2022-e2021-10-005f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a723/9829560/5c3c328e4bf5/jcen-2022-e2021-10-005f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a723/9829560/375548c69b66/jcen-2022-e2021-10-005f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a723/9829560/85f8da7dc9ff/jcen-2022-e2021-10-005f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a723/9829560/e2790befc594/jcen-2022-e2021-10-005f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a723/9829560/5c3c328e4bf5/jcen-2022-e2021-10-005f4.jpg

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本文引用的文献

1
Effectiveness and Technical Considerations of Solitaire Platinum 4×40 mm Stent Retriever in Mechanical Thrombectomy with Solumbra Technique.Solitaire Platinum 4×40毫米支架取栓器在Solumbra技术机械取栓中的有效性及技术考量
J Korean Neurosurg Soc. 2021 Jan;64(1):30-38. doi: 10.3340/jkns.2020.0046. Epub 2020 Aug 7.
2
Unfavorable Vascular Anatomy during Endovascular Treatment of Stroke: Challenges and Bailout Strategies.卒中血管内治疗期间的不良血管解剖结构：挑战与补救策略
J Stroke. 2020 May;22(2):185-202. doi: 10.5853/jos.2020.00227. Epub 2020 May 31.
3
Effect of Balloon Guide Catheter Utilization on the Incidence of Sub-angiographic Peripheral Emboli on High-Resolution DWI After Thrombectomy: A Prospective Observational Study.
球囊导引导管的使用对血栓切除术后高分辨率扩散加权成像上亚血管造影外周栓子发生率的影响：一项前瞻性观察研究。
Front Neurol. 2020 May 7;11:386. doi: 10.3389/fneur.2020.00386. eCollection 2020.
4
Double jeopardy: Failure to deflate stent balloon in rescue angioplasty.双重风险：在补救性血管成形术中未能使支架球囊放气。
Interv Med Appl Sci. 2019 Jun;11(2):128-130. doi: 10.1556/1646.11.2019.16.
5
Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.急性缺血性脑卒中患者早期管理指南：2018 年急性缺血性脑卒中早期管理指南的更新：美国心脏协会/美国卒中协会发布的医疗保健专业人员指南。
Stroke. 2019 Dec;50(12):e344-e418. doi: 10.1161/STR.0000000000000211. Epub 2019 Oct 30.
6
Role of Balloon Guide Catheter in Modern Endovascular Thrombectomy.球囊导引导管在现代血管内血栓切除术中的作用
J Korean Neurosurg Soc. 2020 Jan;63(1):14-25. doi: 10.3340/jkns.2019.0114. Epub 2019 Oct 8.
7
European Stroke Organisation (ESO)- European Society for Minimally Invasive Neurological Therapy (ESMINT) guidelines on mechanical thrombectomy in acute ischemic stroke.欧洲卒中组织（ESO）- 欧洲微创神经治疗学会（ESMINT）急性缺血性卒中机械取栓治疗指南。
J Neurointerv Surg. 2019 Jun;11(6):535-538. doi: 10.1136/neurintsurg-2018-014568.
8
Balloon Guide Catheter Is Beneficial in Endovascular Treatment Regardless of Mechanical Recanalization Modality.无论采用何种机械再通方式，球囊引导导管在血管内治疗中均有益处。
Stroke. 2019 Jun;50(6):1490-1496. doi: 10.1161/STROKEAHA.118.024723. Epub 2019 May 2.
9
Impact of Balloon-Guiding Catheter Location on Recanalization in Patients with Acute Stroke Treated by Mechanical Thrombectomy.球囊引导导管位置对机械取栓治疗的急性脑卒中患者再通的影响。
AJNR Am J Neuroradiol. 2019 May;40(5):840-844. doi: 10.3174/ajnr.A6031. Epub 2019 Apr 4.
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Impact of Balloon Guide Catheter Use on Clinical and Angiographic Outcomes in the STRATIS Stroke Thrombectomy Registry.在 STRATIS 卒中取栓登记研究中，球囊导引导管使用对临床和血管造影结局的影响。
Stroke. 2019 Mar;50(3):697-704. doi: 10.1161/STROKEAHA.118.021126.