The way intraoperative stem sclerotherapy catheter


(57) Abstract:

The invention relates to medicine, namely to surgery, and can be used for intraoperative catheter stem sclerotherapy. Veins balloon catheter and inflate it. During insertion of the catheter from the vein injected with a sclerosing agent. The method allows to completely bleed the vein and evenly to handle the intima of the sclerosant. This increases the effectiveness of the treatment. 1 Il.

The invention relates to medicine, namely vascular surgery.

The closest is the way stem sclerotherapy catheter, consisting in that vein catheter, which inject sclerosant with simultaneous extraction of the catheter. During the introduction of carry out manual compression of the tissues in the projection Vienna to elastic bandaging(Saveliev B. C., D. Konstantinov, Bogachev C. Y. and other Modern view on the sclerotherapy of varicose veins of the lower extremities. Thoracic and cardiovascular surgery. 1992; 7-8: 4-6.)

Reliability obliteration of the vein is provided by bonding the walls of the vessel without thrombosis. To the wall grown together, the intima of the vein should be uniformly treated sclerosant, and the vessel must be compressed. Eserotherapie) above full of bleeding vessel is achieved, resulting increases the risk of postoperative complications.

The objective of the invention is to increase the efficiency sclerosing by full bleeding veins before the introduction of sclerosing substances.

This object is achieved in that before the injection of sclerosing substance into a vein injected with a balloon catheter, which was inflated on the excretion of injected sclerosing substance.

The invention is illustrated in the drawing, which shows the main phase of the operation: in the distal end of the vein (1) introducing a balloon catheter (2) with hole at end (3), after the introduction of the bag is inflated through a syringe (5), in the process of pulling the catheter on him through a syringe (4) pour in sclerosing drug.

The method is as follows.

After mobilization at the mouth of the great saphenous vein cut by 0.7-1 cm distal to the anastomosis to the femoral vein and tied up on the line of anastomosis. On the first impose a second ligature with flashing. In the distal end of the vein introducing a balloon catheter with a hole at the end, after the introduction of the balloon inflate. In the process of pulling the catheter through it pour sclerosing drug, after which the vein periasami: B. I., 57 years. Diagnosis: Varicose disease, the stage of decompensation left, with trophic disorders. Trophic ulcer of the left tibia. The diagnosis is confirmed by phlebography: Deep vein passable, valves saved. Retrograde blood flow is not defined. Large saphenous vein varix changed (diameter 1.5 cm), lower large insolvent perforating veins in the area of the inner ankle; ultrasound deep veins passable identified valvular insufficiency of deep veins of right hip and a large subcutaneous Vienna, deep veins of the leg on the left. The operation has been performed. stage 1: gas endoscopic dissection of perforating veins of the lower leg, stage 2: EAST (instead of removing the trunk of the great saphenous vein on Babcock): great saphenous vein is mobilized at the mouth, crossed at 1 cm distal to the anastomosis to the femoral vein, tied in the line of anastomosis. Over the first overlay and the second ligature with flashing. In the distal hole of Vienna introduced the balloon catheter is inflated in the process of excretion in Vienna introduced sclerosant: 3% p-p trumbower quantity 7 ml After injection of sclerosant Vienna was bandaged. During the introduction was made manual compression of the tissues in the projection of Vienna. In the postoperative period the patient received anasti, healed venous ulcer, no pain. On the 14th day in a satisfactory condition and was discharged home.

The proposed method operated 6 patients with a positive result.

Thus, the method allows to remove blood from a vein before sclerotiorum, which makes it possible, firstly, to eliminate the occurrence of deep vein thrombosis and pulmonary embolism, second: to expand the indications for IOST; sclerotherapy possible when the vessel diameter more than 2 cm, there is no dependence on the thickness of the subcutaneous fat layer (in obese patients), varicose veins under trophic disorders is not an absolute contraindication for YOST.

The way intraoperative stem sclerotherapy catheter, consisting in that vein catheter, which inject sclerosant, characterized in that it further destabilize the vein before injection of sclerosing substances by introducing a balloon catheter, which was inflated on the excretion of injected sclerosing substance.


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1 ex, 1 tbl