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圈套辅助稳定技术在困难导管置入病例中的再次应用

Second Coming of Snare-Assisted Stabilization Technique in Cases of Difficult Catheter Access.

作者信息

Miyamoto Satoshi, Tsuruta Wataro, Egashira Shuhei, Isozaki Jun, Ishigami Daiichiro

机构信息

Department of Endovascular Neurosurgery, Toranomon Hospital, Tokyo, Japan.

出版信息

J Neuroendovasc Ther. 2025;19(1). doi: 10.5797/jnet.tn.2025-0040. Epub 2025 Jun 25.

Abstract

OBJECTIVE

The snare-assisted stabilization technique can address difficult catheter access in cases such as type III aortic arch. This technique can provide additional support to the treatment system, and it has received attention again in the current era of distal access catheter. Because there are a limited number of reports on this technique, the current study showed the details of this technique and also evaluated the usefulness and safety of the snare-assisted stabilization technique.

CASE PRESENTATION

This is a retrospective observational study at a single center. The consequent cases using the snare-assisted stabilization technique from November 2016 to December 2024 were retrospectively reviewed. The main endpoints were morbidity, mortality rate at discharge, and the success ratio of treatments using this technique. This study included 20 patients. The patients' median age was 73 years, and 70% (n = 14) were men. The primary causes of difficult catheter access included torturous or narrow vertebral artery (n = 13, 65%), type III aortic arch (n = 5, 25%), and short-segment common carotid artery proximal to the lesion (n = 2, 10%). The snare-assisted stabilization technique consistently facilitated improved support, resulting in successful procedures in all cases. In 95% (n = 19) of the cases, the procedures were completed without complications.

CONCLUSION

The snare-assisted stabilization technique is effective and safe for improving the guiding system support and addressing catheter access challenges. This technique should come back into the spotlight in the era of distal access catheters.

摘要

目的

圈套器辅助稳定技术可解决诸如Ⅲ型主动脉弓等病例中导管置入困难的问题。该技术可为治疗系统提供额外支持,在当前远端接入导管时代再次受到关注。由于关于该技术的报道数量有限,本研究展示了该技术的细节,并评估了圈套器辅助稳定技术的有效性和安全性。

病例报告

这是一项单中心回顾性观察研究。对2016年11月至2024年12月使用圈套器辅助稳定技术的后续病例进行了回顾性分析。主要终点指标为发病率、出院死亡率以及使用该技术治疗的成功率。本研究纳入了20例患者。患者的中位年龄为73岁,70%(n = 14)为男性。导管置入困难的主要原因包括椎动脉迂曲或狭窄(n = 13,65%)、Ⅲ型主动脉弓(n = 5,25%)以及病变近端的短段颈总动脉(n = 2,10%)。圈套器辅助稳定技术始终有助于提供更好的支持,所有病例均成功完成手术。95%(n = 19)的病例手术完成时无并发症。

结论

圈套器辅助稳定技术在改善引导系统支持和解决导管置入挑战方面是有效且安全的。在远端接入导管时代,该技术应重新受到关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53c1/12206600/cb86c0a1480d/jnet-19-01-2025-0040-g001.jpg

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