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外周血管支架的手术

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发表于 2014-8-6 15:04:00 | 显示全部楼层 |阅读模式
1、 自动扩张支架
  a、根据靶血管的部位选择穿刺插管途径,穿刺后引入导管鞘。
  b、插入球囊导管对血管狭窄部位先行胶囊扩张成形,以便支架顺利抵达靶部位,然后更换内径略大于支架直径的导引导管至病变部位。
  c、经导管用导丝将支架放置器推送至血管狭窄部位,撤去外鞘,支架即自扩张,恢复原形并支撑在血管内。
  d、再用球囊导管进行扩张,使金属丝嵌于斑块组织内,以增加血管内腔的光滑度。
  e、造影观察支架放入位置及扩张效果。

2、 球囊扩张支架
  a、 穿刺插管。
  b、对血管狭窄部位进行胶囊扩张,而后插入导丝,退出球囊导管。
  c、沿导丝引入支架-球囊导管,并置支架于血管狭窄部位。
  d、加压充盈球囊,使支架扩张并支撑在血管狭窄部位。
  e、再换直径略大的球囊导管对支架进行再次扩张,使其稳定置入狭窄部位并保持血管内壁光滑。
  f、造影观察支架支撑位置及成形效果。

3、热记忆支架 略
  非血管内支架手术过程(食道):
  1、 自动扩张支架
  a、 患者采用仰卧位或侧卧位。根据X光片或钡餐进行体表定位。
  b、 让患者咽下造影管或导尿管过咽喉部,当送导丝通过狭窄段时,退出造影管或导尿管。
  c、 沿泰尔茂导丝送入球囊导管进行预扩张。扩张完毕后,退出球囊导管。(可用可不用此步骤)
  d、 经导丝将支架放置器推送至狭窄部位,撤去外鞘,支架即自动扩张,恢复原形并支撑在食道管腔内。
  e、 退出输送器后,再用球囊导管进行扩张,使支架达到一定的直径。

  f、观察支架放入位置及扩张效果。
  2、球囊扩张支架 不适合用于食道。
 
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