Air Embolism During TEVAR: Carbon Dioxide Flushing Decreases the Amount of Gas Released From Thoracic Stent-Grafts During Deployment

被引:37
作者
Rohlffs, Fiona [1 ]
Tsilimparis, Nikolaos [1 ]
Saleptsis, Vasilis [1 ]
Diener, Holger [1 ]
Debus, E. Sebastian [1 ]
Koelbel, Tilo [1 ]
机构
[1] Univ Hosp Hamburg Eppendorf, Univ Heart Ctr, German Aort Ctr, Hamburg, Germany
关键词
air embolism; aorta; aortic aneurysm; carbon dioxide; endovascular procedures; endovascular technique; stroke; thoracic aorta; thoracic endovascular aortic repair; ENDOVASCULAR AORTIC REPAIR; ASCENDING AORTA; EXPERIENCE; ENDOGRAFT; THERAPY; STROKE;
D O I
10.1177/1526602816675621
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose: To investigate the amount of gas released from Zenith thoracic stent-grafts using standard saline flushing vs the carbon dioxide flushing technique. Methods: In an experimental bench setting, 20 thoracic stent-grafts were separated into 2 groups of 10 endografts. One group of grafts was flushed with 60 mL saline and the other group was flushed with carbon dioxide for 5 minutes followed by 60 mL saline. All grafts were deployed into a water-filled container with a curved plastic pipe; the deployment was recorded and released gas was measured using a calibrated setup. Results: Gas was released from all grafts in both study groups during endograft deployment. The average amount of released gas per graft was significantly lower in the study group with carbon dioxide flushing (0.79 vs 0.51 mL, p=0.005). Conclusion: Thoracic endografts release significant amounts of air during deployment if flushed according to the instructions for use. Application of carbon dioxide for the flushing of thoracic stent-grafts prior to standard saline flush significantly reduces the amount of gas released during deployment. The additional use of carbon dioxide should be considered as a standard flush technique for aortic stent-grafts, especially in those implanted in proximal aortic segments, to reduce the risk of air embolism and stroke.
引用
收藏
页码:84 / 88
页数:5
相关论文
共 17 条
[1]   Transcranial Doppler findings during thoracic endovascular aortic repair [J].
Bismuth, Jean ;
Garami, Zsolt ;
Anaya-Ayala, Javier E. ;
Naoum, Joseph J. ;
El Sayed, Hosam F. ;
Peden, Eric K. ;
Lumsden, Alan B. ;
Davies, Mark G. .
JOURNAL OF VASCULAR SURGERY, 2011, 54 (02) :364-369
[2]   Endovascular Aortic Repair Versus Open Surgical Repair for Descending Thoracic Aortic Disease A Systematic Review and Meta-Analysis of Comparative Studies [J].
Cheng, Davy ;
Martin, Janet ;
Shennib, Hani ;
Dunning, Joel ;
Muneretto, Claudio ;
Schueler, Stephan ;
Von Segesser, Ludwig ;
Sergeant, Paul ;
Turina, Marko .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2010, 55 (10) :986-1001
[3]  
Cho Kyung Jae, 2015, Vasc Specialist Int, V31, P67, DOI 10.5758/vsi.2015.31.3.67
[4]   Cerebral Arterial Gas Embolism During Upper Endoscopy [J].
Eoh, Eun J. ;
Derrick, Bruce ;
Moon, Richard .
A & A CASE REPORTS, 2015, 5 (06) :93-94
[5]   Risk factors for perioperative stroke after thoracic endovascular aortic repair [J].
Gutsche, Jacob T. ;
Cheung, Albert T. ;
McGarvey, Michael L. ;
Moser, William G. ;
Szeto, Wilson ;
Carpenter, Jeffrey P. ;
Fairman, Ronald M. ;
Pochettino, Alberto ;
Bavaria, Joseph E. .
ANNALS OF THORACIC SURGERY, 2007, 84 (04) :1195-1200
[6]   Global experience with an inner branched arch endograft [J].
Haulon, Stephan ;
Greenberg, Roy K. ;
Spear, Rafaelle ;
Eagleton, Matt ;
Abraham, Cherrie ;
Lioupis, Christos ;
Verhoeven, Eric ;
Ivancev, Krassi ;
Koelbel, Tilo ;
Stanley, Brendan ;
Resch, Timothy ;
Desgranges, Pascal ;
Maurel, Blandine ;
Roeder, Blayne ;
Chuter, Timothy ;
Mastracci, Tara .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2014, 148 (04) :1709-1716
[7]   Silent Cerebral Ischemia After Thoracic Endovascular Aortic Repair: A Neuroimaging Study [J].
Kahlert, Philipp ;
Eggebrecht, Holger ;
Janosi, Rolf A. ;
Hildebrandt, Heike A. ;
Plicht, Bjoern ;
Tsagakis, Konstantinos ;
Moenninghoff, Christoph ;
Nensa, Felix ;
Mummel, Petra ;
Heusch, Gerd ;
Jakob, Heinz G. ;
Forsting, Michael ;
Erbel, Raimund ;
Schlamann, Marc .
ANNALS OF THORACIC SURGERY, 2014, 98 (01) :53-58
[8]   CARBON-DIOXIDE DIGITAL SUBTRACTION ANGIOGRAPHY - EXPANDING APPLICATIONS AND TECHNICAL EVOLUTION [J].
KERNS, SR ;
HAWKINS, IF .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1995, 164 (03) :735-741
[9]   Carbon Dioxide Flushing Technique to Prevent Cerebral Arterial Air Embolism and Stroke During TEVAR [J].
Koelbel, Tilo ;
Rohlffs, Fiona ;
Wipper, Sabine ;
Carpenter, Sebastian W. ;
Debus, Eike Sebastian ;
Tsilimparis, Nikolaos .
JOURNAL OF ENDOVASCULAR THERAPY, 2016, 23 (02) :393-395
[10]   Microemboli detection on extracorporeal bypass circuits [J].
Lynch, J. E. ;
Riley, J. B. .
PERFUSION-UK, 2008, 23 (01) :23-32