Robert子宮動(dòng)脈導(dǎo)管

1、1會(huì)計(jì)學(xué)Robert子宮動(dòng)脈導(dǎo)管子宮動(dòng)脈導(dǎo)管1. 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。2.導(dǎo)管頭端采用專利的Beacon Tip 不透X線材料，由此增強(qiáng)了X線下的可視性。3.有一個(gè)不透X線金屬標(biāo)記位于導(dǎo)管轉(zhuǎn)彎部位，非常方便導(dǎo)管在髂動(dòng)脈分叉處的操作。4.導(dǎo)管頭端由5F漸變細(xì)為4F,利于插管。5.導(dǎo)管最大流量為12CC/SEC（1200PSI下）優(yōu)勢(shì)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(dòng)脈導(dǎo)管RUC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)折標(biāo)記點(diǎn)位于主動(dòng)脈分叉處，繼續(xù)推送導(dǎo)管進(jìn)入腹主動(dòng)脈呈成袢狀態(tài)，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)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(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 Cath

4、eter is advanced over bifurcation.羅伯特子宮動(dòng)脈導(dǎo)管越過(guò)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)管金屬標(biāo)記到達(dá)髂動(dòng)脈分叉處Catheter is now ready to be reformed.導(dǎo)管準(zhǔn)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

5、 to reform loop.導(dǎo)絲退回到同側(cè)導(dǎo)管中，開(kāi)始向上推并扭轉(zhuǎn)導(dǎo)管，準(zhǔn)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 reformed導(dǎo)管在扭控中Catheter reformed. Starting to search for the left internal iliac.導(dǎo)管開(kāi)始進(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

6、 the right groin.導(dǎo)管進(jìn)入左側(cè)髂內(nèi)動(dòng)脈起始部，開(kāi)始從右側(cè)向下拉導(dǎo)管，以使導(dǎo)管深入髂內(nèi)動(dòng)脈Catheter tip at the origin of the left uterine artery(continuing 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，以深入子宮動(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)脈合適位置，準(zhǔn)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(dǎo)管被推到主動(dòng)脈中，準(zhǔn)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)管扭轉(zhuǎn)后被拉入右側(cè)髂動(dòng)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(dòng)脈導(dǎo)管宮動(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（即使只有基本導(dǎo)管導(dǎo)絲操作經(jīng)驗(yàn)的醫(yī)生，也能很快掌握RUC導(dǎo)管）Catheter has now engaged right internal iliac arte

9、ry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(dǎo)管的時(shí)候應(yīng)該注意防止導(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，即可順利撤出導(dǎo)管。另外您應(yīng)該使用動(dòng)脈血管鞘，以方便導(dǎo)管進(jìn)出。 RUC的缺陷導(dǎo)管必須借助導(dǎo)絲才能順利跨越主動(dòng)脈分叉，分叉夾角較小時(shí)導(dǎo)管不易進(jìn)入對(duì)側(cè)髂動(dòng)脈，造成成袢困難。 距導(dǎo)管頭2cm處是導(dǎo)管不同材質(zhì)和管徑的交接點(diǎn),操作時(shí)因受力不勻容易引起打折，A組發(fā)生1例導(dǎo)管打折，原因就在于此 術(shù)者技術(shù)熟練，操作動(dòng)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(duì)側(cè)髂外動(dòng)脈，推送導(dǎo)管至轉(zhuǎn)折標(biāo)記點(diǎn)位于主動(dòng)脈分叉處，繼續(xù)推送導(dǎo)管進(jìn)入腹主動(dòng)脈呈成袢狀態(tài)，然后下拉導(dǎo)管進(jìn)入同側(cè)或?qū)?cè)子宮動(dòng)脈

12、。 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)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(dǎo)管準(zhǔn)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(kāi)始向上推并扭轉(zhuǎn)導(dǎo)管，準(zhǔn)備成圈Note: The advantage of this catheter is that it allows for contrast to be injected without having