使用IVUS的中央静脉再通道和右心室血栓切除术
1UT Southwestern Department of Radiology, Division of Vascular and Interventional Radiology, University of Texas Southwestern, Dallas, TX; Cleveland Clinic Imaging Institute, Department of Interventional Radiology, Cleveland Clinic Foundation, Cleveland, OH.
Techniques in vascular and interventional radiology
|April 26, 2025
概括
血管内超声波 (IVUS) 增强了中央静脉封闭 (CVOs) 的内血管再通道 (EVR). IVUS提供了详细的内视图,指导治疗和改善结果,同时减少对比度和辐射暴露.
科学领域:
- 干预心脏病学 干预心脏病学
- 血管外科 血管外科
- 医疗成像医学成像
背景情况:
- 中枢静脉封闭 (CVO) 导致显著的发病率,包括静脉拥堵,血栓栓塞和血管通道受损.
- 内血管再通道 (EVR) 是耐火性CVO的主要治疗方法,血管内超声波 (IVUS) 越来越重要.
- 传统的成像缺乏对复杂的CVO至关重要的详细的内洞察力.
研究的目的:
- 审查IVUS在为CVO指导EVR中的作用和应用.
- 突出IVUS在评估病理和程序终点方面的实用性.
- 讨论IVUS在减少并发症和提高成功率方面的好处.
主要方法:
- 使用辐射和侧向发射的IVUS导管用于胸部,腹部和骨盆的内成像.
- 使用IVUS来评估凝块负担,壁的完整性,瘤入侵,闭塞长度和光度.
- 指导EVR程序,包括/的再通道,支架和机械血栓栓切除术 (MTE).
主要成果:
- 与静脉扫描或CT相比,IVUS提供了优越的内可视化.
- IVUS准确地指导复杂的干预,如MTE的自由浮动血栓 (FFT) 和凝块在运输 (CIT).
- IVUS优化了对手术成功的评估,并减少了对比度/辐射暴露,特别是在血液透析患者中.
结论:
- IVUS对于准确的CVO评估和有效的EVR指导至关重要.
- 长期数据证实IVUS增强了技术和临床成功,同时最大限度地减少了并发症.
- 干预医生必须掌握IVUS技术,以获得最佳的CVO治疗结果.
相关概念视频
Cardiac Catheterization II: Right Heart Catheterization
2.2K
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
2.2K
Cardiac Catheterization III: Left Heart Catheterization
1.3K
Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
1.3K
Varicose Veins II: Diagnostic Studies and Interprofessional Care
325
Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
325
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
470
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
470
Venous Thrombosis III: Interprofessional Care
482
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
482
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
760
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
760


