CAJ | 학술논문

目的：探讨在髂动脉闭塞症中使用鹅颈套圈配合0.035英寸泥鳅导丝行内膜下血管成形术的可行性及适用条件。方法2011年10月-2013年5月收治一侧髂动脉完全闭塞患者3例，从对侧股动脉入路顺行导丝进入髂动脉内膜下无法返回真腔，再从患侧股动脉逆行穿刺送入导丝，导管与导丝无法在内膜下对吻，遂用鹅颈套圈于内膜下套住导丝建立轨道，完成血管内成形术。结果3例患者均成功且安全的完成球囊扩张及支架植入术，患者未诉特殊不适。结论髂动脉闭塞症患者在进行内膜下血管成形术时，如导丝无法返回真腔，可考虑在内膜下使用鹅颈套圈配合逆向导丝建立轨道完成血管成形术，但需轻柔操作，注意血管破裂风险。
목적：탐토재가동맥폐새증중사용아경투권배합0.035영촌니추도사행내막하혈관성형술적가행성급괄용조건。방법2011년10월-2013년5월수치일측가동맥완전폐새환자3례，종대측고동맥입로순행도사진입가동맥내막하무법반회진강，재종환측고동맥역행천자송입도사，도관여도사무법재내막하대문，수용아경투권우내막하투주도사건립궤도，완성혈관내성형술。결과3례환자균성공차안전적완성구낭확장급지가식입술，환자미소특수불괄。결론가동맥폐새증환자재진행내막하혈관성형술시，여도사무법반회진강，가고필재내막하사용아경투권배합역향도사건립궤도완성혈관성형술，단수경유조작，주의혈관파렬풍험。
Objective To study the feasibility of using gooseneck snare combined with 0.035 inch loach guidewire for subintimal angioplasty in iliac artery occlusion , and to discuss its clinical indications. Methods During the period from October 2011 to May 2013, 3 cases with unilateral complete iliac artery occlusion were admitted to authors’ hospital. As the guidewire inserted from the healthy side could not returned into the true lumen once it entered into the subintimal space of the iliac artery , the puncture at the diseased side was carried out and the guidewire was pushed into the artery , but the catheter and the guidewire could not converge or anastomose in the subintimal site , gooseneck snare had to be used to grab the guidewire in subintimal site as to establish a path and completed the angioplasty. Results Successful and safe balloon dilatation and stent implantation were accomplished in all the 3 patients , and the patients complained of no special discomfort. Conclusion In performing the subintimal angioplasty for patients with iliac artery occlusion, the use of gooseneck snare combined with retrograde insertion of guidewire should be considered when it occurs that the guidewire can not return into the true lumen after it enters into the subintimal space. Nevertheless, gentle manipulation is first important in order to avoid the possible rupture of vessels.