Clinical outcome of transvascular intervention for complex iatrogenic intravascular foreign bodies

DU Song; YANG Zhou; SUN Long; ZHANG Bin; LI Chao; LI Zhong-hui; XIAO Hang; HU Chun-fang; MOU Wei; HAO Ying-xue

doi:10.11659/jjssx.01E023087

您当前的位置：

首页 >

文章列表页 >

Clinical outcome of transvascular intervention for complex iatrogenic intravascular foreign bodies

Vascular Column | 更新时间：2023-11-24

- Clinical outcome of transvascular intervention for complex iatrogenic intravascular foreign bodies
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 32, Issue 11, Pages: 952-956(2023)
- 作者机构：
  
  1.陆军军医大学第一附属医院血管外科，重庆 400038
  2.陆军军医大学第一附属医院放射科，重庆 400038
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.01E023087
  CLC： R459.9
- Published：25 November 2023，
  
  Received：28 January 2023，
扫描看全文
杜松,杨州,孙龙等.经血管介入治疗复杂医源性血管腔内异物的临床效果[J].局解手术学杂志,2023,32(11):952-956.

DU Song,YANG Zhou,SUN Long,et al.Clinical outcome of transvascular intervention for complex iatrogenic intravascular foreign bodies[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(11):952-956.
杜松,杨州,孙龙等.经血管介入治疗复杂医源性血管腔内异物的临床效果[J].局解手术学杂志,2023,32(11):952-956. DOI： 10.11659/jjssx.01E023087.

DU Song,YANG Zhou,SUN Long,et al.Clinical outcome of transvascular intervention for complex iatrogenic intravascular foreign bodies[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(11):952-956. DOI： 10.11659/jjssx.01E023087.

摘要

目的

探讨经血管介入手术在治疗复杂医源性血管腔内异物中的临床效果。

方法

回顾性分析2019年3月至2022年3月在我院接受介入治疗的3例复杂医源性血管腔内异物患者的临床资料，其中导丝碎裂、刺破血管及穿透周围脏器、局部血栓机化包裹导丝并血管闭塞1例，植入性导管周围血栓形成、粘连血管及心脏瓣膜1例，导丝脱入血管并发静脉血栓形成伴血管狭窄、局部血栓机化包裹导丝1例。经静脉采用钳夹、圈套、绞缠、拖拽、套取等血管腔内介入技术治疗，观察异物取出率及手术相关并发症。

结果

3例患者的异物取出率为100%，其中完全取出2例，部分取出1例（残留约5%）。出现血管损伤1例，其余2例无其他严重并发症。

结论

介入术创伤小，并发症少，异物取出率高，效果显著，可作为复杂医源性血管腔内异物取出的治疗方式。

Abstract

Objective

To investigate the clinical outcome of transvascular interventional surgery in the treatment of complex iatrogenic intravascular foreign bodies.

Methods

The clinical data of 3 patients with complex iatrogenic intravascular foreign bodies who received interventional treatment in our hospital from March 2019 to March 2022 were retrospectively analyzed， including 1 case of guide wire breaking， puncturing blood vessels and penetrating surrounding organs， local thrombus wrapped guide wire and blood vessel occlusion， 1 case of pericatheter thrombosis， adhesion to blood vessels and heart valves， and 1 case of guide wire slipped into blood vessel lead to venous thrombosis complicated by vascular stenosis and local thrombus wrapped guide wire. The intravascular interventional techniques such as clamping，trapping，entangling，dragging and extracting through the transjugular approach were used for the treatment，and the foreign body removal rate and related complications were observed.

Results

The foreign body removal rate of 3 patients was 100%， of which 2 cases were completely removed and 1 case was partially removed （residual about 5%）. Vascular injury occurred in 1 case，and the remaining 2 cases had no other serious complications.

Conclusion

Interventional surgery has the characteristics of less trauma，fewer complications， high extraction rate of foreign body，and remarkable effect，which can be used as the preferred treatment for the removal of complex iatrogenic endovascular foreign bodies.

关键词

介入医源性血管腔内异物

Keywords

interventioniatrogenicintravascular foreign body

references

Ambrosanio G，Arthimulam G，Leone G，et al.Bailouts during neurointervention； novel techniques in tackling coil migration and premature intravascular detachment of microcatheter tip［J］.World Neurosurg，2020，142：167-170.doi：10.1016/j.wneu.2020.06.190http://dx.doi.org/10.1016/j.wneu.2020.06.190.

Haddad PG，Mohamed A，Peden EK.Novel technique of stent retrieval after migration to the right heart［J］.J Vasc Surg Cases Innov Tech，2021，7（4）：781-784.doi：10.1016/j.jvscit.2021.09.008http://dx.doi.org/10.1016/j.jvscit.2021.09.008.

Shamseldin M，Stier A，Hosten N，et al.Endovascular retrieval of a dislocated pushable coil in the common hepatic artery using a cerebral stent retriever［J］.CVIR Endovasc，2021，4（1）：34.doi：10.1186/s42155-021-00224-8http://dx.doi.org/10.1186/s42155-021-00224-8.

王伟明，施森，曾宏，等.腔内介入治疗血管内异物：附4例报告并文献复习［J］.中国普通外科杂志，2020，29（6）：693-698.doi：10.7659/j.issn.1005-6947.2020.06.009http://dx.doi.org/10.7659/j.issn.1005-6947.2020.06.009.

吕天石，曹守金，王健，等.血管腔内技术用于取出血管腔内异物的有效性及安全性［J］.中国介入影像与治疗学，2020，17（7）：442-444.doi：10.13929/j.issn.1672-8475.2020.07.014http://dx.doi.org/10.13929/j.issn.1672-8475.2020.07.014.

刘喆，何颂跃.脑室-腹腔分流术后致肺动脉血管内异物医疗损害1例［J］.法医学杂志，2020，36（1）：124-125.doi：10.12116/j.issn.1004-5619.2020.01.024http://dx.doi.org/10.12116/j.issn.1004-5619.2020.01.024.

Turner DD，Sommers SC.Accidental passage of a poly-ethylene catheter from cubital vein to right atrium；report of a fatal case［J］.N Engl J Med，1954，251：744-745.doi：10.1056/NEJM195410282511806http://dx.doi.org/10.1056/NEJM195410282511806.

陈忠，杨耀国.腔内血管技术在医源性血管损伤诊断与治疗中临床价值［J］.中国实用外科杂志，2014，34（12）：1138-1140.doi：10.7504/CJPS.ISSN1005-2208.2014.12.09http://dx.doi.org/10.7504/CJPS.ISSN1005-2208.2014.12.09.

Correia R，Garcia A，Camacho N，et al.Intravascular foreign body retrieval［J］.Port J Card Thorac Vasc Surg，2022，29（2）：45-50.doi：10.48729/pjctvs.277http://dx.doi.org/10.48729/pjctvs.277.PMID：35780413.

Jud P，Portugaller R，Bohlsen D，et al.Successful retrieval of an embolized vascular closure device （Angio-Seal®） after peripheral angioplasty［J］.Cardiovasc Intervent Radiol，2017，40（6）：942-946.doi：10.1007/s00270-017-1565-9http://dx.doi.org/10.1007/s00270-017-1565-9.

Matsui Y，Asai T，Oishi A，et al.Minimally invasive extraction of a catheter from the heart without thoracotomy［J］.Ann Thorac Surg，2022，114（6）：e451-e453.doi：10.1016/j.athoracsur.2022.02.019http://dx.doi.org/10.1016/j.athoracsur.2022.02.019.

Funaki B.Catheter pinch off with foreign body retrieval［J］.Semin Intervent Radiol，2017，34（1）：81-84.doi：10.1055/s-0036-1597769http://dx.doi.org/10.1055/s-0036-1597769.

Rossi UG，Rollandi GA，Ierardi AM，et al.Materials and techniques for percutaneous retrieval of intravascular foreign bodies［J］.J Vasc Access，2019，20（1）：87-94.doi：10.1177/1129729818785051http://dx.doi.org/10.1177/1129729818785051.

Joya-Rita H，Tarek S，Tuckey LC，et al.Nexplanon migration into a subsegmental branch of the pulmonary artery：a case report and review of the literature［J］.Medicine （Baltimore），2020，99：e18881.doi：10.1097/MD.0000000000018881http://dx.doi.org/10.1097/MD.0000000000018881.

Carraro do Nascimento V，De Villiers L，Chia GS，et al.Aspiration technique for percutaneous endovascular retrieval of contraceptive device embolized to the pulmonary vasculature［J］.Radiol Case Rep，2020，24，16（3）：571-574.doi：10.1016/j.radcr.2020.12.049http://dx.doi.org/10.1016/j.radcr.2020.12.049.

Floridi C，Nocchi-Cardim L，De Chiara M，et al.Intravascular foreign bodies：what the radiologist needs to know［J］.Semin Ultrasound CT MR，2015，36（1）：73-79.doi：10.1053/j.sult.2014.11.001http://dx.doi.org/10.1053/j.sult.2014.11.001.

Kim TI，Kostiuk V，Baumann D，et al.Complex endovascular retrieval of an intravascular foreign body［J］.J Vasc Surg Cases Innov Tech，2021，7（2）：361-363.doi：10.1016/j.jvscit.2021.03.014http://dx.doi.org/10.1016/j.jvscit.2021.03.014.

中国医师协会介入医师分会，中华医学会放射学分会介入专业委员会，中国静脉介入联盟.下腔静脉滤器置入术和取出术规范的专家共识（第2版）［J］.中华医学杂志，2020，100（27）：2092-2101.doi：10.3760/cma.j.cn112137-20200317-00804http://dx.doi.org/10.3760/cma.j.cn112137-20200317-00804.

Park SM，Son JW，Hong KS，et al.Pathological significance of tissue trapped in retrieved OptEase vena cava filter at 18th day after installation in patient with deep vein thrombosis［J］.Yonsei Med J，2017，58（3）：662-664.doi：10.3349/ymj.2017.58.3.662http://dx.doi.org/10.3349/ymj.2017.58.3.662.

Ayx I，Goessmann H，Hubauer H，et al.Interventional removal of intravascular medical devices：methods and technical success［J］.Rofo，2016，188（6）：566-573.doi：10.1055/s-0042-104204http://dx.doi.org/10.1055/s-0042-104204.

Wilson GJ，van-Noesel MM，Hop WC，et al.The catheter is stuck：complications experienced during removal of a totally implantable venous access device.A single-center study in 200 children［J］.J Pediatr Surg，2006，41（10）：1694-1698.doi：10.1016/j.jpedsurg.2006.05.065http://dx.doi.org/10.1016/j.jpedsurg.2006.05.065.

成芳，傅麒宁，何佩仪，等.输液导管相关静脉血栓形成防治中国专家共识（2020版）［J］.中国实用外科杂志，2020，40（4）：377-383.doi：10.19538/j.cjps.issn1005-2208.2020.04.03http://dx.doi.org/10.19538/j.cjps.issn1005-2208.2020.04.03.

秦定文，施海彬，刘圣，等.自制下腔静脉支架式滤器安全性的动物实验研究［J］.介入放射学杂志，2008，17（5）：349-352.doi：10.3969/j.issn.1008-794X.2008.05.012http://dx.doi.org/10.3969/j.issn.1008-794X.2008.05.012.

陈国平，顾建平，楼文胜，等.一种自制下腔静脉滤过器的初步动物实验研究［J］.南京医科大学学报（自然科学版），2006，26（8）：732-734.doi：10.3969/j.issn.1007-4368.2006.08.035http://dx.doi.org/10.3969/j.issn.1007-4368.2006.08.035.

Rebecca S，Melita C，Andrea F，et al.The catheter to vein ratio and rates of symptomatic venous thromboembolism in patients with a peripherally inserted central catheter （PICC）：a prospective cohort study［J］.Int J Nurs Stud，2015，52（3）：677-685.doi：10.1016/j.ijnurstu.2014.12.002http://dx.doi.org/10.1016/j.ijnurstu.2014.12.002.

Gorski LA.The 2016 infusion therapy standards of practice［J］.Home Healthc Now，2017，35（1）：10-18.doi：10.1097/NHH.0000000000000481http://dx.doi.org/10.1097/NHH.0000000000000481.

Trerotola SO，Stavropoulos SW，Mondschein JI，et al.Triple-lu-men peripherally inserted central catheter in patients in the critical care unit：prospective evaluation［J］.Radiology，2010，256（1）：312-320.doi：10.1148/radiol.10091860http://dx.doi.org/10.1148/radiol.10091860.

中华医学会呼吸病学分会肺栓塞与肺血管病学组，中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会，全国肺栓塞与肺血管病防治协作组.肺血栓栓塞症诊治与预防指南［J］.中华医学杂志，2018，98（14）：1060-1087.doi：10.3760/cma.j.issn.0376-2491.2018.14.007http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2018.14.007.

Kearon C，Akl EA，Ornelas J，et al.Antithrombotic therapy for VTE disease：CHEST guideline and expert panel report［J］.Chest，2016，149（2）：315-352.doi：10.1016/j.chest.2015.11.026http://dx.doi.org/10.1016/j.chest.2015.11.026.

中华医学会外科学分会血管外科学组.深静脉血栓形成的诊断和治疗指南（第三版）［J］.中国血管外科杂志（电子版），2017，9（4）：250-257.doi：10.3969/j.issn.1674-7429.2017.04.003http://dx.doi.org/10.3969/j.issn.1674-7429.2017.04.003.

De Maeseneer MG，Kakkos SK，Aherne T，et al.Editor's choice - European Society for Vascular Surgery （ESVS） 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs［J］.Eur J Vasc Endovasc Surg，2022，63：184-267.doi：10.1016/j.ejvs.2021.12.024http://dx.doi.org/10.1016/j.ejvs.2021.12.024.

Supomo，Handy D.An unusual foreign body in the heart：a case report［J］.Ann Thorac Cardiovasc Surg，2018，24（4）：205-207.doi：10.5761/atcs.cr.17-00117http://dx.doi.org/10.5761/atcs.cr.17-00117.

Leitman M，Vered Z.Foreign bodies in the heart［J］.Echocardiography，2015，32（2）：365-371.doi：10.1111/echo.12795http://dx.doi.org/10.1111/echo.12795.

Thomas J，Sinclair-Smith B，Bloomfield D，et al.Non-surgical retrieval of a broken segment of steel spring guide from the right atrium and inferior vena cava［J］.Circulation，1964，30：106-108.doi：10.1161/01.cir.30.1.106http://dx.doi.org/10.1161/01.cir.30.1.106.

Zhou H，Wang B，Pan J，et al.Percutaneous snare-retrieval of intracardiac thrombus under fluoroscopic and transesophageal echocardiography guidance：case report and systematic review［J］.Front Cardiovasc Med，2023，10：1127131.doi：10.3389/fcvm.2023.1127131http://dx.doi.org/10.3389/fcvm.2023.1127131.

Carroll MI，Ahanchi SS，Kim JH，et al.Endovascular foreign body retrieval［J］.J Vasc Surg，2013，57（2）：459-463.doi：10.1016/j.jvs.2012.01.092http://dx.doi.org/10.1016/j.jvs.2012.01.092.

Ghannam JS，Cooper KJ，Bundy JJ，et al.Endobronchial forceps-assisted removal of gianturco Z-stents from the right atrium［J］.Ann Vasc Surg，2019，56：350.e1-350.e4.doi：10.1016/j.avsg.2018.07.037http://dx.doi.org/10.1016/j.avsg.2018.07.037.

Kumar R，Rana SS，Kumar S，et al.Management of accidental and iatrogenic foreign body injuries to heart-case series［J］.J Clin Diagn Res，2017，11（3）：PE01-PE04.doi：10.7860/JCDR/2017/23847.9336http://dx.doi.org/10.7860/JCDR/2017/23847.9336.

Sood S，Srinivasan S.Retrievingembolized peripherally inserted central catheter：a novel two step technique［J］.Radiol Case Rep，2021，17（3）：531-536.doi：10.1016/j.radcr.2021.11.044http://dx.doi.org/10.1016/j.radcr.2021.11.044.

Galzerano G，de Donato G，Pasqui E，et al.A simple rescue maneuver to retrieve intravascular foreign body：the triple wire twisting technique［J］.Ann Vasc Surg，2021，75：523-526.doi：10.1016/j.avsg.2021.03.035http://dx.doi.org/10.1016/j.avsg.2021.03.035.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

No data

Related Author

No data

Related Institution

No data

⁰