Robert子宮動脈導管

1、1會計學Robert子宮動脈導管子宮動脈導管1. 這個導管可以非常容易的進入同側(cè)以及對側(cè)髂內(nèi)動脈。2.導管頭端采用專利的Beacon Tip 不透X線材料，由此增強了X線下的可視性。3.有一個不透X線金屬標記位于導管轉(zhuǎn)彎部位，非常方便導管在髂動脈分叉處的操作。4.導管頭端由5F漸變細為4F,利于插管。5.導管最大流量為12CC/SEC（1200PSI下）優(yōu)勢ORDER NUMBERTORCON NB ADVANTAGE CATHETERBeacon Tip stainless steel braided nylon French Size5.0Wire GuideDiameter.035 in

2、chLength90TipConfigurationRUCHNBR5.0-35-90-P-NS-RUCRADIOPAQUEMARKERROBERTS UTERINE ARTERY ACCESS CATHETER羅伯特子宮動脈導管RUC兩種插管方法RUC插入對側(cè)髂外動脈，推送導管至轉(zhuǎn)折標記點位于主動脈分叉處，繼續(xù)推送導管進入腹主動脈呈成袢狀態(tài)，然后下拉導管進入同側(cè)或?qū)?cè)子宮動脈。 在導絲引導下將RUC直接插入對側(cè)子宮動脈，完成介入治療后，利用導絲在對側(cè)臀上動脈成袢，再行同側(cè)子宮動脈插管 。常規(guī)應使用第一種方法 View of pelvic arteriogram shows a Varrel c

3、ontralateral flush catheter used for positioning of wire over the bifurcation.A wire guide is placed through the Varrel contralateral flushcatheter and positioned in the contralateral iliac artery. 導管在導絲導引下進入對側(cè)髂動脈！The Varrel contralateral flush catheter is removed and the Roberts Uterine Artery Cath

4、eter is advanced over bifurcation.羅伯特子宮動脈導管越過髂動脈分叉進入對側(cè)髂動脈Marker positioned at the top of bifurcation (mag shot). 導管金屬標記到達髂動脈分叉處Catheter is now ready to be reformed.導管準備塑性，以進入對側(cè)髂內(nèi)動脈Wire guide is now pulled back on other side of radiopaque marker. The Roberts Uterine Artery Catheter is being pushed up

5、 to reform loop.導絲退回到同側(cè)導管中，開始向上推并扭轉(zhuǎn)導管，準備成圈Catheter reforming up from right groin.扭控導管，使對側(cè)導管頭端指向髂內(nèi)動脈Catheter mostly reformed導管在扭控中Catheter reformed. Starting to search for the left internal iliac.導管開始進入左側(cè)髂內(nèi)動脈Catheter now in the origin of the left internal iliacartery. Catheter is being pulled down at

6、 the right groin.導管進入左側(cè)髂內(nèi)動脈起始部，開始從右側(cè)向下拉導管，以使導管深入髂內(nèi)動脈Catheter tip at the origin of the left uterine artery(continuing to pull down).導管頭端進入左側(cè)子宮動脈起始部（繼續(xù)向下拉導管，以深入子宮動脈）Catheter is now well into the left uterine artery.Ready to start embolizing.導管到達子宮動脈合適位置，準備做栓塞治療Post-embolization of the left uterine art

7、ery左側(cè)栓塞結(jié)束Catheter has been pushed up into the aorta, the tip twisted, and the right common iliac artery engaged.導管被推到主動脈中，準備做右側(cè)髂內(nèi)動脈選擇性插管Catheter now being pulled down, bringing tip into the iliac vessel searching for internal iliac artery. 導管扭轉(zhuǎn)后被拉入右側(cè)髂動脈Note: The advantage of this catheter is that it

8、 allows for contrast to be injected without having to continually manipulate the wire in andout in order to move the catheter (as you would need to do with a Cobra Catheter). 使用羅伯特子羅伯特子宮動脈導管宮動脈導管，可以極為容易的做雙側(cè)子宮動脈插管，縮短手術時間（即使只有基本導管導絲操作經(jīng)驗的醫(yī)生，也能很快掌握RUC導管）Catheter has now engaged right internal iliac arte

9、ry導管進入右側(cè)髂內(nèi)動脈Catheter positioned in right uterine artery導管進入右側(cè)子宮動脈Post uterine artery embolization of right uterine artery栓塞結(jié)束Note: When getting ready to remove catheter, be careful of twists that may have built up in the catheter and may make it prone to knotting. Catheter is positioned back over th

10、e left iliac system, and once the marker is pulled down to the bifurcation one can keep pulling thecatheter and pull it through the sheath. I have always used a sheath in the groin with these cases.Anne C. Roberts, M.D.Professor of RadiologyChief of Vascular & Interventional RadiologyUCSD Medica

11、l CenterLa Jolla, CA撤出導管的時候應該注意防止導管打結(jié)，您只需將導管頭端重新送回到對側(cè)髂動脈，即可順利撤出導管。另外您應該使用動脈血管鞘，以方便導管進出。 RUC的缺陷導管必須借助導絲才能順利跨越主動脈分叉，分叉夾角較小時導管不易進入對側(cè)髂動脈，造成成袢困難。 距導管頭2cm處是導管不同材質(zhì)和管徑的交接點,操作時因受力不勻容易引起打折，A組發(fā)生1例導管打折，原因就在于此 術者技術熟練，操作動作輕柔 宮外孕終止妊娠宮外孕終止妊娠RUC兩種插管方法RUC插入對側(cè)髂外動脈，推送導管至轉(zhuǎn)折標記點位于主動脈分叉處，繼續(xù)推送導管進入腹主動脈呈成袢狀態(tài)，然后下拉導管進入同側(cè)或?qū)?cè)子宮動脈

12、。 在導絲引導下將RUC直接插入對側(cè)子宮動脈，完成介入治療后，利用導絲在對側(cè)臀上動脈成袢，再行同側(cè)子宮動脈插管 。常規(guī)應使用第一種方法 View of pelvic arteriogram shows a Varrel contralateral flush catheter used for positioning of wire over the bifurcation.Catheter is now ready to be reformed.導管準備塑性，以進入對側(cè)髂內(nèi)動脈Wire guide is now pulled back on other side of radiopaque marker. The Roberts Uterine Artery Catheter is being pushed up to reform loop.導絲退回到同側(cè)導管中，開始向上推并扭轉(zhuǎn)導管，準備成圈Note: The advantage of this catheter is that it allows for contrast to be injected without having