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目的探讨动脉内灌注盐酸替罗非班在处理支架辅助弹簧圈栓塞颅内动脉瘤时术中急性血栓的有效性及安全性。方法收集2013年1月至2017年6月11例行颅内动脉瘤栓塞术中发生血栓患者,发生血栓后,均于微导管内靶向灌注盐酸替罗非班6ml,同时静脉泵注5ml/h,然后每5~10分钟造影观察血管溶通情况,直至血栓消失或血管开通。术后进行CT或MRI随访,观察有无脑梗塞或脑出血。结果 11例术中造影血管均完全再通,术后第1天、第7天及术后1月行头颅CT或MRI检查,均未发现与手术相关脑梗塞和脑出血的发生。结论支架辅助弹簧圈栓塞颅内动脉瘤时,术中出现急性血栓并发症时,经动脉靶向灌注盐酸替罗非班是一种安全、有效的方法。 相似文献
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M. Perry S. Oktay J.C. Muskivitch 《Minimally invasive therapy & allied technologies》2013,22(4):165-171
Understanding the behaviour of implantable medical devices is of obvious importance. The potential for failure of a medical device can often be associated with issues related to cyclic loading of the device, and material fatigue. Detailed finite element simulations to evaluate the fatigue of stents allow the engineer to assess potential failures. The engineer can then use the analysis results to modify the design and prevent failure, without making and testing numerous physical devices. Complete understanding of the mechanical behaviour of a stent provided by finite element analysis has the benefits of facilitating effective design, helping to reduce time to market and minimising the potential for unwanted failures. 相似文献
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Sabin J. Bozso Jeevan Nagendran Roderick G.G. MacArthur Michael W.A. Chu Bob Kiaii Ismail El-Hamamsy Raymond Cartier Ali Shahriari Michael C. Moon 《The Journal of thoracic and cardiovascular surgery》2019,157(5):1763-1771
Objectives
We describe the Canadian results of the Ascyrus Medical Dissection Stent (AMDS), a novel partially uncovered aortic arch hybrid graft implanted antegrade during hypothermic circulatory arrest to promote true lumen expansion and enhance aortic remodeling.Methods
From March 2017 to February 2018, 16 consecutive patients (66 ± 12 years; 38% female) presented with acute type A aortic dissections and underwent emergent surgical aortic repair with AMDS implantation. All patients presented with DeBakey I aortic dissection, with evidence of malperfusion in 50% (n = 8) of patients. All cases were performed under hypothermic circulatory arrest with an additional average duration for AMDS implantation time of 2.1 minutes.Results
All 16 device implantations were successful. Overall 30-day mortality was 6.3% (n = 1) and stroke occurred in 6.3% (n = 1) of cases. There was no incidence of device-related aortic injury or aortic arch branch vessel occlusion. During the follow-up period, 12 patients had completed at least 1 postoperative computed tomography scan. At initial follow-up computed tomography scan, complete or partial thrombosis, and remodeling of the aortic arch occurred in 91.7% of cases (n = 11/12) and in the proximal descending thoracic aorta, complete or partial thrombosis, and remodeling occurred in 91.7% (n = 11/12).Conclusions
Preliminary results suggest that the AMDS is a safe, feasible and reproducible adjunct to current surgical approaches for acute DeBakey I aortic dissection repair. Further, the AMDS manages malperfusion and promotes early positive remodeling in the aortic arch and distal dissected segments, with favorable FL closure rates at follow-up. Ongoing follow-up will provide additional insight into the long-term effects of the AMDS. 相似文献69.
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