在锁骨下动脉迂曲的情况下,使用头部左转手法将导线推进升主动脉,从而挽救右桡动脉心导管术

Mohammad Reza Movahed
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引用次数: 0

摘要

经由右桡动脉进行心导管检查的并发症发生率较低,因此越来越受欢迎。但是,经右侧桡动脉进行心导管手术存在一些独特的挑战,可能导致手术失败。其中一个主要挑战是在非常曲折的锁骨下动脉中将导丝推进升主动脉。深吸气动作是克服导丝推进到主动脉的重要动作之一。然而,在某些情况下,导丝会进入降主动脉,很难在升主动脉中重新定位。在本病例中,我们描述了一个锁骨下动脉非常迂曲的病例,尽管重新定位了导管并进行了深吸气操作,但仍无法将导线推进升主动脉。然而,在指示患者将头向左侧移动后,导线很容易就推进到了升主动脉。本病例报告介绍了在这种困难情况下一种易于操作的方法,它可以挽救经右桡动脉途径开始的手术。
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Saving right radial cardiac catheterization with tortuous subclavian artery using head left turning maneuver for facilitating wire advancement into the ascending aorta
Cardiac catheterization via the right radial artery is associated with a lower complication rate and is gaining popularity. However, there are unique challenges that can lead to procedural failure. One of the major challenges is advancing guide wire into the ascending aorta in a very tortuous subclavian artery. The deep inspiratory maneuver is one of the important maneuvers to overcome wire advancement into the aorta. However, in some cases, the wire will enter the descending aorta with great difficulty in repositioning in the ascending aorta. In this case, we describe a case of a very tortuous subclavian artery that prevents wire advancement into the ascending aorta despite repositioning the catheter and performing deep inspiratory maneuvers. However, after instructing the patient to move her head to the left, wire advancement into the ascending aorta was easily achieved. In this case report, an easy-to-perform maneuver is described in these tough situations that can save the procedure that was started via the right radial route.
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