经血管介入治疗复杂医源性血管腔内异物的临床效果

杜松; 杨州; 孙龙; 张彬; 李超; 李中会; 肖航; 胡春芳; 牟玮; 郝迎学

doi:10.11659/jjssx.01E023087

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经血管介入治疗复杂医源性血管腔内异物的临床效果

血管专栏 | 更新时间：2023-11-24

- 经血管介入治疗复杂医源性血管腔内异物的临床效果
- Clinical outcome of transvascular intervention for complex iatrogenic intravascular foreign bodies
- 局解手术学杂志 2023年32卷第11期页码：952-956
- 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：
  
  郝迎学，E-mail：haoyingxue@hotmail.com
- 基金信息：
  
  军队医学科技青年培育计划(20QNYP028)
- DOI：10.11659/jjssx.01E023087
  中图分类号： R459.9
- 纸质出版日期：2023-11-25，
  
  收稿日期：2023-01-28，
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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

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