Robert子宮動(dòng)脈導(dǎo)管ppt課件

1、DEMONSTRATION OF ROBERTS UTERINE ARTERY ACCESS CATHETER羅伯特子宮動(dòng)脈導(dǎo)管引見蘇州大學(xué)附屬第一醫(yī)院介入科Intended UseUsed for gaining access to the uterine artery, as well as for embolizing vessels in the pelvic region.用于選擇性進(jìn)入子宮動(dòng)脈，或是用作其它盆腔動(dòng)脈的栓塞 這個(gè)導(dǎo)管可以非常容易的進(jìn)入同側(cè)以及對(duì)側(cè)髂內(nèi)動(dòng)脈。導(dǎo)管頭端采用專利的Beacon Tip 不透X線資料，由此加強(qiáng)了X線下的可視性。有一個(gè)不透X線金屬標(biāo)志位于導(dǎo)管轉(zhuǎn)彎

2、部位，非常方便導(dǎo)管在髂動(dòng)脈分叉處的操作。導(dǎo)管頭端由5F漸變細(xì)為4F,利于插管。導(dǎo)管最大流量為12CC/SEC1200PSI下優(yōu)勢(shì)ORDER NUMBERTORCON NB ADVANTAGE CATHETERBeacon Tip stainless steel braided nylon French Size5.0Wire GuideDiameter.035 inchLength90TipConfigurationRUCHNBR5.0-35-90-P-NS-RUCRADIOPAQUEMARKERROBERTS UTERINE ARTERY ACCESS CATHETER羅伯特子宮動(dòng)脈導(dǎo)管RU

3、C兩種插管方法RUC插入對(duì)側(cè)髂外動(dòng)脈，推送導(dǎo)管至轉(zhuǎn)機(jī)標(biāo)志點(diǎn)位于自動(dòng)脈分叉處，繼續(xù)推送導(dǎo)管進(jìn)入腹自動(dòng)脈呈成袢形狀，然后下拉導(dǎo)管進(jìn)入同側(cè)或?qū)?cè)子宮動(dòng)脈。 在導(dǎo)絲引導(dǎo)下將RUC直接插入對(duì)側(cè)子宮動(dòng)脈，完成介入治療后，利用導(dǎo)絲在對(duì)側(cè)臀上動(dòng)脈成袢，再行同側(cè)子宮動(dòng)脈插管 。常規(guī)應(yīng)運(yùn)用第一種方法 View of pelvic arteriogram shows a Varrel contralateral flush catheter used for positioning of wire over the bifurcation.A wire guide is placed through the Var

4、rel contralateral flushcatheter and positioned in the contralateral iliac artery. 導(dǎo)管在導(dǎo)絲導(dǎo)引下進(jìn)入對(duì)側(cè)髂動(dòng)脈！The Varrel contralateral flush catheter is removed and the Roberts Uterine Artery Catheter is advanced over bifurcation.羅伯特子宮動(dòng)脈導(dǎo)管越過髂動(dòng)脈分叉進(jìn)入對(duì)側(cè)髂動(dòng)脈Marker positioned at the top of bifurcation (mag shot). 導(dǎo)管金

5、屬標(biāo)志到達(dá)髂動(dòng)脈分叉處Catheter is now ready to be reformed.導(dǎo)管預(yù)備塑性，以進(jìn)入對(duì)側(cè)髂內(nèi)動(dòng)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(dǎo)絲退回到同側(cè)導(dǎo)管中，開場(chǎng)向上推并改動(dòng)導(dǎo)管，預(yù)備成圈Catheter reforming up from right groin.扭控導(dǎo)管，使對(duì)側(cè)導(dǎo)管頭端指向髂內(nèi)動(dòng)脈Catheter mostly r

6、eformed導(dǎo)管在扭控中Catheter reformed. Starting to search for the left internal iliac.導(dǎo)管開場(chǎng)進(jìn)入左側(cè)髂內(nèi)動(dòng)脈Catheter now in the origin of the left internal iliacartery. Catheter is being pulled down at the right groin.導(dǎo)管進(jìn)入左側(cè)髂內(nèi)動(dòng)脈起始部，開場(chǎng)從右側(cè)向下拉導(dǎo)管，以使導(dǎo)管深化髂內(nèi)動(dòng)脈Catheter tip at the origin of the left uterine artery(continuing

7、 to pull down).導(dǎo)管頭端進(jìn)入左側(cè)子宮動(dòng)脈起始部繼續(xù)向下拉導(dǎo)管，以深化子宮動(dòng)脈Catheter is now well into the left uterine artery.Ready to start embolizing.導(dǎo)管到達(dá)子宮動(dòng)脈適宜位置，預(yù)備做栓塞治療Post-embolization of the left uterine artery左側(cè)栓塞終了Catheter has been pushed up into the aorta, the tip twisted, and the right common iliac artery engaged.導(dǎo)管被推到自

8、動(dòng)脈中，預(yù)備做右側(cè)髂內(nèi)動(dòng)脈選擇性插管Catheter now being pulled down, bringing tip into the iliac vessel searching for internal iliac artery. 導(dǎo)管改動(dòng)后被拉入右側(cè)髂動(dòng)脈Note: The advantage of this catheter is that it allows for contrast to be injected without having to continually manipulate the wire in andout in order to move the c

9、atheter (as you would need to do with a Cobra Catheter). 運(yùn)用羅伯特子宮動(dòng)脈導(dǎo)管，可以極為容易的做雙側(cè)子宮動(dòng)脈插管，縮短手術(shù)時(shí)間即使只需根本導(dǎo)管導(dǎo)絲操作閱歷的醫(yī)生，也能很快掌握RUC導(dǎo)管Catheter has now engaged right internal iliac artery導(dǎo)管進(jìn)入右側(cè)髂內(nèi)動(dòng)脈Catheter positioned in right uterine artery導(dǎo)管進(jìn)入右側(cè)子宮動(dòng)脈Post uterine artery embolization of right uterine artery栓塞終了Note

10、: 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 the 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 Medical CenterLa Jolla, CA撤出導(dǎo)管的時(shí)候應(yīng)該留意防止導(dǎo)管打結(jié)，您只需將導(dǎo)管頭端重新送回到對(duì)側(cè)髂動(dòng)脈