Tsim kom muaj kev nkag tau ruaj khov yog lub hauv paus ntawm kev phais neurointerventional. Kev nkag mus yog hais txog txoj kev vascular hiccup los ntawm qhov chaw puncture mus rau lub hom phiaj cov hlab ntsha rau kev kho mob, tseem hu ua "kev nkag mus". Yuav ua li cas los tsim kom muaj kev nkag tau thiab hom kev qhia cov khoom siv catheter yog qhov tseem ceeb. Intravascular kev cuam tshuam yog txoj kev siv ntau tshaj plaws rau kev kho mob intracranial aneurysms, thiab tsim kom muaj kev nkag tau zoo yog thawj kauj ruam hauv kev kho mob aneurysm embolization. Xaiv qhov tsim nyog embolization nkag yog qhov tsim nyog lav rau kev ua tiav ntawm kev kho mob aneurysm embolization. Kab lus no qhia txog cov kev xaiv rau kev nkag mus rau hauv intracranial aneurysm embolization.
Thaum lub sij hawm aneurysm embolization, kev nkag tau zoo yuav tsum ua kom tau raws li peb yam: ruaj khov, tuab thiab siab. Kev ruaj ntseg yog qhov tseem ceeb tshaj plaws uas yuav tsum tau muaj rau cov channel, uas tuaj yeem muab kev txhawb nqa txaus rau kev ua haujlwm distal kom tsis txhob swb nce thiab nqis los cuam tshuam rau kev ua haujlwm hauv lub cev, thiab xyuas kom meej tias cov channel tsis cuam tshuam rau cov ntshav ntws. Thickness yog raws li kev ruaj ntseg, uas txhais tau hais tias lub puab txoj kab uas hla ntawm cov channel, tshwj xeeb tshaj yog thaum nws yog tsim nyog los ua kom haum raws li ntau yam ntawm cov kav dej, xyuas kom meej tias kev sib txhuam ntawm ib leeg yog tsis loj heev nyob rau hauv lub hauv paus ntawm kev haumxeeb. Siab txhais tau hais tias nyob rau hauv lub hauv paus ntawm "kev ruaj ntseg" thiab "thickness", lub siab dua cov channel, qhov zoo dua, uas yog, qhov ze tshaj qhov kawg ntawm cov channel yog mus rau lub hom phiaj embolization, qhov zoo dua.
1. Multi-channel system embolization
Rau qhov loj dua aneurysm embolization, thiaj li yuav ua tiav denser embolization los yog zoo dua tiv thaiv cov hlab ntsha nyob ib ncig ntawm lub aneurysm, nws yog tsim nyog los siv ntau microcatheters nyob rau hauv lub channel tib lub sij hawm. Feem ntau embolization microcatheter yog 17 qhov system (microcatheter taub hau sab hauv kab 0.017 ntiv tes), thiab feem ntau ntawm stent microcatheter yog 21 system. Lub 6F qhia catheter tsuas tuaj yeem ua tau ob lub microcatheters ntawm 17 qhov system + 21 system tib lub sijhawm, thiab 7F qhia catheter tuaj yeem ua rau ob lub microcatheters 17 thiab ib qho 21 system microcatheter. Yog li ntawd, tus kws phais yuav tsum ntsuas qhov zoo thiab qhov tsis zoo los xaiv ua ntej ua haujlwm.
2. Distal aneurysm embolization
Rau distal aneurysm embolization, qhov aneurysm nyob deb thiab lub microcatheter nyuaj rau kho. Rau kev nyab xeeb, nws raug nquahu kom xaiv qhov nruab nrab catheter raws li cov channel tiv thaiv kom ntseeg tau tias cov kab ke channel tuaj yeem ncav cuag qhov siab txaus. Nyob rau tib lub sijhawm, qhov teeb meem ntawm qhov system ntev yuav tsum tau txiav txim siab.
Cov hlab ntsha aneurysm-cov kabmob yog nyias heev, thiab nws yuav tsum tau txiav txim siab seb nws puas tuaj yeem ua rau ntau lub microcatheters. Lub microguidewire tuaj yeem muab tso rau ntawm stent microcatheter. Tom qab embolization tiav, lub microguidewire hloov nrog microcatheter, thiab tom qab ntawd cov stent raug tso tawm. Thaum xaiv ib txoj kev, txoj kev ntev thiab nyias nyias tuaj yeem txiav txim siab.
3. Tortuous intravascular txoj kev
Thaum ua haujlwm aneurysm embolization, cov hlab ntsha uas muaj txoj hauv kev tortuous, xws li sab hauv carotid lossis vertebral artery, feem ntau yuav tsum tau siv cov catheter nruab nrab los ua ib feem ntawm txoj hauv kev los pab nws mus txog qhov siab xav tau. Rau tortuosity nyob rau hauv qis kawg txoj kev, xws li lub aortic arch, descending aorta, thiab iliac femoral artery, ib tug 6F ntev sheath yog siv los ntawm cov pa 8F qhia catheter rau txoj kev, uas muaj qhov zoo ntawm kev txuag ntev thiab zoo stability. .
Nyob rau hauv luv luv, tsim ib txoj kev zoo yog lub hauv paus rau kev vam meej embolization ntawm aneurysms. Rau kev kho mob aneurysm embolization ntau dua, kev npaj yuav tsum tau ua ua ntej ua ntej kev phais. Txoj kev embolization ntawm qhov aneurysm, txoj hauv kev ntawm lub raj xa dej, qhov ntev ntawm qhov system, kev ua tiav ntawm txoj kev tortuosity ntawm txoj kev qis kawg, thiab qhov ua tau ntawm txoj kev yuav tsum tau ua tiav los txiav txim siab tsim txoj hauv kev zoo kom ua haujlwm. tuaj yeem nqa tau yooj yim thiab nyab xeeb.