Cantarelli M J, de Paola A de A, Alves C M, Souza J A, Castello Júnior H J, Hermann J L, Lamounier E N, Guimarães R F, Portugal O P, Martinez Filho E E
Escola Paulista de Medicina, São Paulo.
Arq Bras Cardiol. 1993 Mar;60(3):171-5.
To report our experience on percutaneous vascular foreign body retrieval and to analyse current techniques employed.
From 1985 to 1991, 15 (0.18%) of 7,963 procedures performed in the Cardiac Catheterization Laboratory-Hospital São Paulo were intravascular foreign body retrieval: 9 (60%) intracath, 4 (26.8%) diagnostic catheters, one Swan Ganz catheter entrapped at superior cava vein and one fragment of angioplasty guide-wire in the circumflex branch of the left coronary artery. The snare technique was used in 11 cases, a endomyocardial bioptome device in 1 case and modified snare technique for the intracoronary wire fragment retrieval was used in 1 case. In two cases of embolized fragment in peripheral arteries, no attempt was done for retrieval.
All (100%) of the 13 attempted procedures were successful. The two foreign bodies not removed had an uneventful follow-up.
The snare technique for percutaneous retrieval of intravascular foreign bodies is safe and has excellent results. The management peripheral fragments is not well defined yet.
报告我们在经皮血管异物取出方面的经验,并分析当前所采用的技术。
1985年至1991年期间,圣保罗医院心脏导管实验室进行的7963例手术中有15例(0.18%)为血管内异物取出术:9例(60%)为心内导管,4例(26.8%)为诊断导管,1例为被困于上腔静脉的 Swan Ganz 导管,1例为左冠状动脉回旋支内的血管成形术导丝碎片。11例采用圈套技术,1例采用心内膜活检钳装置,1例采用改良圈套技术取出冠状动脉内导丝碎片。在外周动脉栓塞碎片的2例中,未尝试取出。
13例尝试的手术全部(100%)成功。未取出的两个异物随访情况良好。
经皮取出血管内异物的圈套技术安全且效果极佳。外周碎片的处理方法尚未明确。