SOLITAIRE颅内支架介入治疗.ppt

优化方法： 解脱中： 确保微导管中持续快速滴注生理盐水 避免消毒针插在脂肪层 支架近端标记与微导管远端标记之间距离2mm 支架推送导丝近端在干燥的操作台表面 确保卸掉微导管与支架推送导丝上的力量 * 国外医生经验 方法： 针头处滴几滴生理盐水 按‘Stop’ 重置，按‘Start’ 再次解脱 换用BSC的解脱器 * * 假阴性释放（解脱了） 医生看到支架解脱但解脱盒10秒后仍未报警 (解脱盒设定程序为解脱后5秒报警）: 建议等待解脱时间至2分钟，透视下辨别 CR00049 Rev.B Not available for sale in the United States 中断解脱 CR00049 Rev.B Not available for sale in the United States * 中断解脱并继续解脱 按“STOP”可以中断 “timer”停止计时 电流(0.0 mA) 和电压 (“-.-”) 被切断. 重新开始请短按 (1 秒) “START”. 电流和电压重新显示，“ timer”继续计时 CR00049 Rev.B Not available for sale in the United States * 线路连接导致的解脱中断 如果患者方的连接中断, 解脱盒可以识别并长报警及“Detach”灯亮。 检查线路，确保正确连接。 按STOP，“timer”数值将归0。 按START 重新开始。 CR00049 Rev.B Not available for sale in the United States * 重置Timer 重新解脱（ timer 重新显示“0.0”并重新计时）可以 长按START重置所有参数 Timer归00.00. 常规步骤解脱。 CR00049 Rev.B Not available for sale in the United States Stenting Techniques * Single Stent Use of a single stent: Place stent, detach, place coils thru the struts Place stent, place coils thru the struts, detach Place catheter, place stent so catheter is ‘jailed’ along the stent, place coils Place the stent, detach, let it endothelialize for a few days, go back in and coil thru the struts Usage of stent as a temporary assist – reinforces the advantage of deployment and retrieval – for cases that are not amendable to balloons and where the physician doesn’t want to leave in a stent permanently * Multiple stents Stent in Stent technique: Several stents might be needed to cover the neck area Some physicians will put stents ‘in each other’ to make their own ‘flow diversion’ product X – or Y - stenting: A second stent is brought in through the first stent and deployed. Kissing Technique: The stents are deployed next to each other * Stenting Techniques Technique Why it is done Where it is done Pros Cons Single stent Wide-necked aneurysm from single parent vessel ICA, MCA, ACA, VA, BA, PCA Endovascular reconstruction of wide-necked aneurysms X/Y-stenting Wide-necked aneurysm involving two major vessels Bi-furcation, i.e., ACOM c