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【J Vasc Surg】应用CO2造影剂指导主动脉瘤腔内修复
Catheter-less angiography for endovascular aortic aneurysm repair: A new application of carbon dioxide as a contrast agent
Enrique Criado, MDa, Loay Kabbani, MDa, Kyung Cho, MDb
Received 28 March 2008; accepted 28 April 2008. published online 16 July 2008.
Objective
Avoidance of nephrotoxic contrast agents during endovascular repair of abdominal aortic aneurysms (EVAR) may reduce the incidence of renal dysfunction following the procedure. Carbon dioxide (CO2) angiography is a safe alternative to iodinated contrast media vastly under-utilized by vascular surgeons. We herein describe our experience with a simple angiographic technique using CO2 for EVAR guidance that does not require a separate angiographic catheter.
Methods
Eighteen patients underwent EVAR using angiography with CO2 delivered through the endograft sheath. The renal and hypogastric arteries were localized for endograft deployment exclusively with CO2 in all patients. Completion angiography was done with CO2 in all patients and an additional angiogram with iodinated media was done in 13 cases.
Results
All endograft deployments were done successfully with CO2 angiography injected through the endograft delivery systems and femoral access sheaths. Additional iodinated media completion angiography did not modify the procedure in any case. All patients were discharged within two days after surgery. There were no ischemic or systemic complications related to CO2 administration. Follow-up CT-scan revealed well positioned endografts with the expected patent renal and hypogastric arteries in all patients, and no additional endoleaks. No significant deterioration in renal function occurred in any case.
Conclusion
Carbon dioxide angiography conducted through the endograft delivery sheath is reliable for endograft deployment, safe, non-toxic and inexpensive. In addition, it may expedite EVAR by eliminating a number of angiographic catheter placements and exchanges during the procedure. This favorable experience warrants further utilization of this technique. Catheter-less angiography for endovascular aortic aneurysm repair: A new application of carbon dioxide as a contrast agent
非导管造影术在主动脉瘤腔内修补术中的应用：二氧化碳作为对比剂的新用途
Enrique Criado, MDa, Loay Kabbani, MDa, Kyung Cho, MDb
Received 28 March 2008; accepted 28 April 2008. published online 16 July 2008.
收到：2008-03-28 修回：008-04-28 在线出版：2008-07-16
Objective
Avoidance of nephrotoxic contrast agents during endovascular repair of abdominal aortic aneurysms (EVAR) may reduce the incidence of renal dysfunction following the procedure. Carbon dioxide (CO2) angiography is a safe alternative to iodinated contrast media vastly under-utilized by vascular surgeons. We herein describe our experience with a simple angiographic technique using CO2 for EVAR guidance that does not require a separate angiographic catheter.
目的：在腹主动脉瘤修补术(EVAR)中避免应用肾毒性造影剂可以减少术后身功能不全的发生率。二氧化碳(CO2)血管造影术作为碘化造影术的安全的替代方法仍未被血管外科医师充分应用。在此我们总结我们应用CO2作为EVAR指引剂的简单血管造影技术的经验，这种造影术不需造影导管。
Methods
Eighteen patients underwent EVAR using angiography with CO2 delivered through the endograft sheath. The renal and hypogastric arteries were localized for endograft deployment exclusively with CO2 in all patients. Completion angiography was done with CO2 in all patients and an additional angiogram with iodinated media was done in 13 cases.
方法：8名患者接受了腔内腹主动脉瘤修补术。术中通过鞘管注入CO2作为对比剂。所有患者均在腔内开伞之前均应用CO2对肾动脉及髂内动脉进行定位。所有患者均成功实施了CO2作为对比剂的血管造影术，其中13名患者还接受了碘化造影术。
Results
All endograft deployments were done successfully with CO2 angiography injected through the endograft delivery systems and femoral access sheaths. Additional iodinated media completion angiography did not modify the procedure in any case. All patients were discharged within two days after surgery. There were no ischemic or systemic complications related to CO2 administration. Follow-up CT-scan revealed well positioned endografts with the expected patent renal and hypogastric arteries in all patients, and no additional endoleaks. No significant deterioration in renal function occurred in any case.
结果：所有应用CO2造影术的腔内支架植入术均获得成功，术中通过股动脉鞘及内置物释放系统注入CO2。附加的碘化造影术显示所有手术均不需进行修正。所有患者均在术后2天出院。所有患者均没有发生缺血和CO2吸收相关的系统并发症。随后的随访CT扫描显示所有患者的腔内植入物位置良好，肾动脉及髂内动脉均通畅，没有发生内漏。所有患者均没发生严重的肾功能损害。
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作者:admin@医学,生命科学 2010-12-26 17:14
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