Schwarzenberg H, Müller-Hülsbeck S, Heller M
Klinik für Radiologische Diagnostik, Christian-Albrechts-Universität zu Kiel, Arnold-Heller-Strasse 9, D-24105 Kiel, Germany.
Cardiovasc Intervent Radiol. 1998 Jan-Feb;21(1):73-5. doi: 10.1007/s002709900216.
In a 74-year-old woman, a Dacron-covered Cragg endoprosthesis was implanted into the left superficial femoral artery after successful recanalization of a 6-cm-long occlusion. At 4.5 months after discharge the endoprosthesis was occluded. In order to perform a thrombectomy, an Amplatz thrombectomy device (ATD) was activated and advanced into the occluded graft. Suddenly, a mechanical failure of the ATD occurred. Extraction of the ATD was achieved only after repeated attempts at rotating motion and jerky pullback maneuvers. The most likely explanation is that one of the graft-struts had advanced into the tip of the ATD and resulted in a broken drive shaft. Recanalization was completed by performing percutaneous transluminal angioplasty and pharmacological thrombolysis with recombinant human-tissue plasminogen activator. In conclusion, users of the ATD have to be aware of interactions of the ATD with the struts of implanted stents or grafts during thrombectomy.
在一名74岁女性患者中，一段6厘米长的闭塞段成功再通后，将一个覆盖涤纶的克拉格（Cragg）血管内假体植入左股浅动脉。出院后4.5个月，该血管内假体发生闭塞。为了进行血栓切除术，启动了一个安普拉斯血栓切除装置（ATD）并将其推进到闭塞的移植物中。突然，ATD发生机械故障。仅在反复尝试旋转运动和急促回撤操作后才成功取出ATD。最可能的解释是移植物的一个支杆进入了ATD的尖端并导致驱动轴断裂。通过经皮腔内血管成形术和使用重组人组织型纤溶酶原激活剂进行药物溶栓完成了再通。总之，ATD的使用者必须意识到在血栓切除术中ATD与植入支架或移植物的支杆之间可能存在相互作用。
