CN115813435A - Method for positioning lower limb artery lesion position by contrast in intravascular ultrasound combined operation - Google Patents
Method for positioning lower limb artery lesion position by contrast in intravascular ultrasound combined operation Download PDFInfo
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- CN115813435A CN115813435A CN202211396016.XA CN202211396016A CN115813435A CN 115813435 A CN115813435 A CN 115813435A CN 202211396016 A CN202211396016 A CN 202211396016A CN 115813435 A CN115813435 A CN 115813435A
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Abstract
The invention relates to a method for positioning a lower limb artery lesion position by combining angiography in intravascular ultrasound and angiography, and belongs to the technical field of biological medicines. Carrying out intracavity ultrasonic detection on a diseased section of a blood vessel by using an intravascular ultrasonic diagnostic apparatus, marking the position of a lesion on an ultrasonic image when the diseased part is observed by an ultrasonic catheter, and observing the anatomical position of the ultrasonic catheter on a screen of a digital subtraction angiography machine by contrast; the position of the ultrasonic catheter is the accurate anatomical position of a lesion part; by the invention, when lower limb arterial vessel lesion is evaluated by using intravascular ultrasound, the anatomical position of the lesion and the position of a near-far normal vessel can be accurately positioned by combining intraoperative radiography, so that a balloon or a stent with a proper size can be conveniently selected to treat the lesion, and more accurate reference is provided for clinical decision.
Description
Technical Field
The invention relates to a method for positioning the position of a lower limb arterial lesion by radiography in a vascular intracavity ultrasound combined operation, belonging to the technical field of biological medicines.
Background
At present, with the progress of aging of the population, the incidence rate of lower limb arterial lesions is higher and higher. The application of intravascular ultrasound is also becoming more and more widespread for more accurate assessment of lesion properties and measurement of lesion vessel diameter. Compared with angiography, the intravascular ultrasound can dynamically observe the property of lesion, more accurately measure the diameter of a blood vessel, and provide more accurate reference value for selecting the diameters of the saccule and the stent for clinically treating intravascular lesion in the cavity. However, the defects are that the intravascular ultrasound can only observe the existence of the lesion, but cannot accurately locate the anatomical position of the lesion, and the proximal and distal positioning during subsequent treatment by using a balloon or a stent is affected, so that the clinical effect is affected. Therefore, how to accurately locate the anatomical positions of the diseased blood vessel and the near-distal normal blood vessel is a technical difficulty which needs to be solved urgently in the technical field at present.
Disclosure of Invention
The invention aims to solve the technical problem of accurately positioning a diseased blood vessel and the anatomical position of the proximal end and the distal end of the diseased blood vessel.
In order to solve the technical problem, the invention provides a method for positioning the position of a lower limb artery lesion by contrast in a vascular intracavity ultrasound combined operation, which comprises the following steps:
step 1: starting an intravascular ultrasonic diagnostic apparatus and adjusting the intravascular ultrasonic diagnostic apparatus to be in an intravascular ultrasonic mode;
step 2: radiography is carried out on the side limbs with pathological changes, one-time radiography including pathological change sections and near-far end blood vessels at pathological change positions is ensured, and the operation table and the digital subtraction angiography machine are kept not to move after radiography;
and step 3: sending the ultrasonic catheter to the proximal end of the vascular lesion, and recording an ultrasonic image in a vascular cavity; pushing the intracavity ultrasonic catheter to advance from the proximal end of the lesion to the distal end of the lesion, marking the position of the lesion on an ultrasonic image in the vascular cavity when the ultrasonic catheter observes the narrowest part of the lesion, and observing the anatomical position of the ultrasonic catheter on a screen of a digital subtraction angiography machine through radiography; the anatomical position is marked on the limb blood vessel displayed on the screen of the digital subtraction angiography machine, so that the lesion part observed by the ultrasonic catheter can be accurately positioned on the angiography image;
and 4, step 4: and the positions of the lesion near-end normal blood vessel, the lesion far-end normal blood vessel and the lesion near-end and far-end are marked on the screen of the digital subtraction angiography machine and the intravascular ultrasonic diagnostic apparatus respectively.
And 5: withdrawing the intracavity ultrasonic catheter, measuring the size of the normal blood vessel diameter marked in the step 4 on an intravascular ultrasonic diagnostic apparatus, and accordingly selecting a balloon or a stent with a proper size, wherein the length of the balloon or the stent is determined by the length between the near-far ends of the lesion marked on the screen of the digital subtraction angiography machine;
step 6: after the lesion treatment is finished, the intraluminal ultrasonic catheter is introduced again by the same method, and whether the stenosis at the proximal and distal ends of the just marked lesion blood vessel and the narrowest part of the lesion is relieved or not is observed; if the treatment is not satisfactory, the position of the residual lesion is positioned again for treatment; if the treatment is satisfactory, the ultrasound catheter in the blood vessel cavity is withdrawn, and the operation is ended.
Preferably, the advancing speed of the push intracavity ultrasonic catheter in the step 3 from the proximal end of the lesion to the distal end of the lesion is 0.5cm/s.
Preferably, the ultrasonic catheter is delivered to the proximal end of the vascular lesion in the step 3 by utilizing a guide wire with the nominal diameter of 0.014in to deliver the ultrasonic catheter to the proximal end of the lesion.
The invention provides a system constructed by a method for positioning a lower limb artery lesion position by combining intravascular ultrasound with angiography, and the system comprises a program for executing the method.
The invention provides a storage device, wherein a plurality of instructions are stored in a storage medium, and the instructions execute the steps in the method for positioning the artery lesion position of the lower limb in the intravascular ultrasound combined contrast operation.
Compared with the prior art, the invention has the following beneficial effects:
1. the method provided by the invention can be used for accurately positioning the dissection of the arterial vascular lesion of the lower limb.
2. The method provided by the invention can more accurately measure the diameters of normal blood vessels at the near and far ends of the saccule and the stent, and is convenient for further selecting the saccule and the stent with proper specifications.
Detailed Description
In order to make the invention more comprehensible, preferred embodiments are described in detail as follows:
the invention provides a method for positioning a lower limb artery lesion position by contrast in an intravascular ultrasound combined operation, which comprises the following steps of:
step 1: starting an intravascular ultrasonic diagnostic apparatus and adjusting the intravascular ultrasonic diagnostic apparatus to be in an intravascular ultrasonic mode;
step 2: radiography is carried out on the side limbs with pathological changes, one-time radiography including pathological change sections and near-far end blood vessels at pathological change positions is ensured, and the operation table and the digital subtraction angiography machine are kept not to move after radiography;
and step 3: sending the ultrasonic catheter to the proximal end of the vascular lesion, and recording an ultrasonic image in the vascular cavity; pushing the intracavity ultrasonic catheter to advance from the proximal end of the lesion to the distal end of the lesion, marking the position of the lesion on an ultrasonic image in the vascular cavity when the ultrasonic catheter observes the narrowest part of the lesion, and observing the anatomical position of the ultrasonic catheter on a screen of a digital subtraction angiography machine through radiography; the anatomical position is marked on the limb blood vessel displayed on the screen of the digital subtraction angiography machine, so that the lesion part observed by the ultrasonic catheter can be accurately positioned on the angiography image;
and 4, step 4: and marking the positions of a lesion near-end normal blood vessel, a lesion far-end normal blood vessel and a lesion near-end and far-end on a digital subtraction angiography machine screen and an intravascular ultrasonic diagnostic apparatus respectively.
And 5: withdrawing the intracavity ultrasound catheter, measuring the size of the diameter of the normal blood vessel marked in the step 4 on an intravascular ultrasound diagnostic apparatus, and accordingly selecting a balloon or a stent with a proper size, wherein the length of the balloon or the stent is determined by the length between the near-far ends of the lesion marked on a screen of a digital subtraction angiography machine;
and 6: after the lesion treatment is finished, the intraluminal ultrasonic catheter is introduced again by the same method, and whether the stenosis at the proximal and distal ends of the just marked lesion blood vessel and the narrowest part of the lesion is relieved or not is observed; if the treatment is not satisfactory, the position of the residual lesion is positioned again for treatment; if the treatment is satisfactory, the ultrasound catheter in the blood vessel cavity is withdrawn, and the operation is ended.
The advancing speed of the pushing intracavity ultrasonic catheter from the proximal end of the lesion to the distal end of the lesion in the step 3 is 0.5cm/s.
And 3, delivering the ultrasonic catheter to the proximal end of the vascular lesion by using a guide wire with the nominal diameter of 0.014 in.
The invention provides a system constructed by a method for positioning a lower limb artery lesion position by combining intravascular ultrasound with angiography, and the system comprises a program for executing the method.
The invention provides a storage device, wherein a plurality of instructions are stored in the storage medium, and the instructions execute the steps in the method for positioning the lesion position of the lower limb artery by contrast in the intravascular ultrasound combined operation.
By the method, when lower limb arterial vessel lesion is evaluated by using intravascular ultrasound, the anatomical position of the lesion and the position of a near-far normal vessel can be accurately positioned by combining intraoperative radiography, and more accurate reference is provided for clinical decision.
The invention can obtain the applied principle:
1) The ultrasonic catheter in the vascular cavity can be clearly developed under X-ray;
2) Compared with angiography, the intravascular ultrasound can more accurately judge the nature and severity of lesion;
3) After the lesion exists in the intravascular ultrasound recognition, the anatomical position of the ultrasonic catheter on the whole lower limb, namely the anatomical part of the lesion, can be accurately positioned by angiography.
The invention has the advantages that:
the specific anatomical position of lesion is accurately positioned by applying the digital subtraction angiography in the cooperation of an intravascular ultrasonic diagnostic apparatus and the operation; the diameter of a normal blood vessel at the near and far ends of a lesion is accurately measured, the specification of a stent or a saccule is guided to be selected and the near and far ends are positioned, and the clinical effect is improved.
Examples
1) Opening an intravascular ultrasonic diagnostic apparatus (such as Volcano), adjusting the intravascular ultrasonic diagnostic apparatus to be in an intravascular ultrasound mode, and inputting basic information of a patient and operator information;
2) After the femoral artery is punctured successfully, a 5F short sheath is placed, and a 6F short sheath (ipsilateral forward puncture) or a 6F mountain-turning sheath (contralateral reverse puncture) is exchanged;
3) Performing contrast on the side limbs of the lesion, ensuring that one-time contrast comprises the lesion section and the proximal and distal blood vessels of the lesion, and keeping an operating bed and a Digital Subtraction Angiography (DSA) machine from moving after contrast;
4) A catheter is matched with a guide wire to pass through a lesion section, and a 0.014 guide wire is exchanged; opening the ultrasonic catheter in the blood vessel cavity, connecting the tail end of the ultrasonic catheter in the blood vessel cavity with an intravascular ultrasonic diagnostic apparatus, then conveying the ultrasonic catheter into the proximal end of a lesion by using a 0.014 guide wire, clicking a ring down button on a machine of the intravascular ultrasonic diagnostic apparatus at a position corresponding to a normal blood vessel, and standing by;
5) Clicking a 'recording' button on an intravascular ultrasonic diagnostic apparatus machine to start recording the intravascular ultrasound image. Slowly pushing the intracavity ultrasonic catheter to advance from the proximal end of the lesion to the distal end of the lesion at a speed of about 0.5cm/s, clicking a 'mark' button on an intravascular ultrasonic diagnostic apparatus machine when the ultrasonic catheter observes the narrowest part of the lesion, marking the position of the lesion in an ultrasonic image in the vascular cavity, observing the anatomical position of the ultrasonic catheter on a DSA screen by contrast, and marking the anatomical position on the limb blood vessel displayed on the DSA screen by an assistant by using a marker pen, so that the lesion part observed by the ultrasonic catheter can be accurately positioned on the image by contrast.
6) By the same method, the positions of a lesion near-end normal blood vessel, a lesion far-end normal blood vessel and a lesion near-end and far-end are marked on a DSA screen and an intravascular ultrasonic diagnostic instrument machine respectively.
7) Withdrawing the intracavity ultrasonic catheter, measuring the size of the normal blood vessel diameter marked in the previous step on an intravascular ultrasonic diagnostic instrument machine, and accordingly selecting a balloon or a stent with a proper size to treat the lesion, wherein the length of the balloon and the stent is determined by the length between the near-far ends of the lesion marked on the DSA screen.
8) After the lesion treatment is finished, the intraluminal ultrasonic catheter is introduced again in the same way, and whether the stenosis at the proximal and distal ends of the just marked lesion blood vessel and the narrowest part of the lesion is relieved or not is observed. If the treatment is not satisfactory, the position of the residual lesion is positioned again for treatment; if the treatment is satisfactory, the ultrasonic catheter and the 0.014 guide wire in the blood vessel cavity are withdrawn, and the puncture point is pressure-packed. The operation is finished.
While the invention has been described with respect to a preferred embodiment, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the spirit and scope of the invention. Those skilled in the art can make various changes, modifications and equivalent arrangements, which are equivalent to the embodiments of the present invention, without departing from the spirit and scope of the present invention, and which may be made by utilizing the techniques disclosed above; meanwhile, any changes, modifications and variations of the above-described embodiments, which are equivalent to those of the technical spirit of the present invention, are within the scope of the technical solution of the present invention.
Claims (5)
1. A method for positioning the position of a lower limb artery lesion by contrast in a vascular intracavity ultrasound combined operation is characterized by comprising the following steps:
step 1: starting an intravascular ultrasonic diagnostic apparatus and adjusting the intravascular ultrasonic diagnostic apparatus to be in an intravascular ultrasonic mode;
step 2: the limb at the side of the pathological change is contrasted, so that the condition that the primary contrast comprises the pathological change section and the near-distal end blood vessel of the pathological change part is ensured, and the operation table and the digital subtraction angiography machine do not need to move after the contrast;
and step 3: sending the ultrasonic catheter to the proximal end of the vascular lesion, and recording an ultrasonic image in the vascular cavity; pushing the intracavity ultrasonic catheter to advance from the proximal end of the lesion to the distal end of the lesion, marking the position of the lesion on an ultrasonic image in the vascular cavity when the ultrasonic catheter observes the narrowest part of the lesion, and observing the anatomical position of the ultrasonic catheter on a screen of a digital subtraction angiography machine through radiography; the anatomical position is marked on the limb blood vessel displayed on the screen of the digital subtraction angiography machine, so that the lesion part observed by the ultrasonic catheter can be accurately positioned on the contrastographic image;
and 4, step 4: and marking the positions of a lesion near-end normal blood vessel, a lesion far-end normal blood vessel and a lesion near-end and far-end on a digital subtraction angiography machine screen and an intravascular ultrasonic diagnostic apparatus respectively.
And 5: withdrawing the intracavity ultrasonic catheter, measuring the size of the normal blood vessel diameter marked in the step 4 on an intravascular ultrasonic diagnostic apparatus, and accordingly selecting a balloon or a stent with a proper size, wherein the length of the balloon or the stent is determined by the length between the near-far ends of the lesion marked on the screen of the digital subtraction angiography machine;
step 6: after the lesion treatment is finished, the intraluminal ultrasonic catheter is introduced again by the same method, and whether the stenosis at the proximal and distal ends of the just marked lesion blood vessel and the narrowest part of the lesion is relieved or not is observed; if the treatment is not satisfactory, the position of the residual lesion is positioned again for treatment; if the treatment is satisfactory, the ultrasound catheter in the blood vessel cavity is withdrawn, and the operation is ended.
2. The method for locating the position of an artery lesion of a lower limb through angiography and ultrasound combined with endovascular ultrasonography according to claim 1, wherein the speed of advancing the ultrasound catheter from the proximal end of the lesion to the distal end of the lesion in the step 3 is 0.5cm/s.
3. The method for locating the position of a lower limb artery lesion through angiography combined with intravascular ultrasound according to claim 1, wherein the ultrasound catheter is delivered to the proximal end of the lesion in step 3 by using a guidewire with a nominal diameter of 0.014 in.
4. The system constructed by the method for locating the position of a lower limb artery lesion through angiography in combination with intravascular ultrasound according to claims 1 to 3, wherein the system comprises a program for executing the method according to claims 1 to 3.
5. A storage device, wherein the storage medium stores instructions for performing the steps of the method for locating a lesion in a lower extremity artery with angiography in ultrasound-coupled intravascular space as claimed in any one of claims 1 to 3.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202211396016.XA CN115813435A (en) | 2022-11-09 | 2022-11-09 | Method for positioning lower limb artery lesion position by contrast in intravascular ultrasound combined operation |
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| Application Number | Priority Date | Filing Date | Title |
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| CN202211396016.XA CN115813435A (en) | 2022-11-09 | 2022-11-09 | Method for positioning lower limb artery lesion position by contrast in intravascular ultrasound combined operation |
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| Publication Number | Publication Date |
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| CN115813435A true CN115813435A (en) | 2023-03-21 |
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| CN202211396016.XA Pending CN115813435A (en) | 2022-11-09 | 2022-11-09 | Method for positioning lower limb artery lesion position by contrast in intravascular ultrasound combined operation |
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