Endovascular Surgery and Devices (eBook)

Editor Zaiping Jing is the director of Department of Vascular Surgery, Changhai Hospital, Affiliated to Second Military Medical University (Naval Military Medical University), Shanghai, China. Editor Huajuan Mao is the person in charge of surgery devices at the same department. Editor Weihui Dai is a professor at School of Management, Fudan University, Shanghai, China.

Foreword 1 5
Foreword 2 7
Preface 1 9
Preface 2 10
Preface 3 11
Contents 13
List of Contributors and Editors 15
Introduction 19
Part I: Basics of Endovascular Surgery and Devices 21
1: Development History of Endovascular Surgery and Devices 22
1.1 Percutaneous Endovascular Balloon Angioplasty 23
1.2 Endovascular Stent Angioplasty 23
1.3 Endovascular Graft Exclusion for Artery Dilatations 25
1.4 Summary 26
References 26
2: Conventional Endovascular Devices 27
2.1 The Puncture Needle 27
2.1.1 Product Structure 27
2.1.2 Models and Specifications 27
2.1.3 Brand Information 28
2.1.3.1 Cook Puncture Needle 28
2.1.3.2 Terumo Puncture Needle 28
2.2 Vascular Sheath 28
2.2.1 Product Structure 28
2.2.1.1 Vascular Sheath 28
2.2.1.2 The Dilator 28
2.2.2 Models and Specifications 28
2.2.3 Brand Information 29
2.2.3.1 Terumo Vascular Sheath 29
2.2.3.2 St. Jude Vascular Sheath 29
2.2.3.3 Cook Vascular Sheath 29
2.2.3.4 Cordis Vascular Sheath 30
2.2.3.5 Arrow Vascular Sheath 30
2.2.3.6 Gore Vascular Sheath 30
2.2.3.7 LifeTech Adjustable Curved Sheath 30
2.3 Wire 31
2.3.1 Product Structure 31
2.3.1.1 Wire Structure 31
Shaping Section 31
Transition Section 32
Support Section 32
The Shaft 32
2.3.1.2 Functions and Performance Parameters of Wire 32
2.3.1.3 Application of Wire in Different Vascular Lesions 33
2.3.2 Specifications and Models 33
2.3.2.1 Length 33
2.3.2.2 The Outer Diameter 33
2.3.2.3 External Shape 33
2.3.3 Brand Information 34
2.3.3.1 Terumo Exchanging Wire 34
2.3.3.2 Boston Scientific Wire 34
2.3.3.3 Cook Wire 35
2.3.3.4 Abbott Wire 35
2.3.3.5 Asahi Wire 35
2.4 Catheter 35
2.4.1 Product Structure 35
2.4.1.1 Catheter’s Materials 35
PE 35
PU 35
PVC 36
PTFE 36
2.4.1.2 Catheter Structure 36
2.4.2 Specifications and Models 36
2.4.3 Brand Information 37
2.4.3.1 AngioDynamics Catheter 37
2.4.3.2 Cook Catheter 37
2.4.3.3 Terumo Catheter 38
2.4.3.4 Cordis Catheter 38
2.5 Special Catheter 38
2.5.1 Support Catheter 38
2.5.1.1 Productive Structure 38
2.5.1.2 Features and Models 38
2.5.1.3 Brand Information 38
CXI Support Catheter 38
TrailBlazer Support Catheter 38
2.5.2 The Microcatheter 39
2.5.2.1 Product Structure 39
2.5.2.2 Features and Models 39
2.5.2.3 Brand Information 39
Renegade STC 18 Microcatheter 39
Echelon Microcatheter 39
2.5.3 Embolectomy Catheter 39
2.5.3.1 Product Structure 39
2.5.3.2 Features and Models 40
2.5.4 Thrombolytic Catheter 40
2.5.4.1 UniFuse Perfusion System 40
Product Structure 40
Features and Models 40
2.5.4.2 Fountain Perfusion System 41
Product Structure 41
Features and Models 41
2.6 Y Valve 41
2.6.1 The Rotary Hemostatic Valve 41
2.6.2 The Wire Introducer 41
2.6.3 The Wire Controller 41
2.7 Connector 42
2.7.1 General Connector 42
2.7.2 The High-Pressure Connector 42
2.8 Inflation Device 42
2.9 Vascular Closure Device 42
2.9.1 Angio-Seal Vascular Closure Device 43
2.9.1.1 Product Structure 43
2.9.1.2 Features and Models 43
2.9.1.3 Operation Procedures 43
2.9.2 Perclose Proglide Suture-Mediated Closure System 43
2.9.2.1 Product Structure 43
2.9.2.2 Features and Models 43
2.9.2.3 Operation Procedures 44
2.9.3 Starclose SE Vascular Closure System 44
2.9.3.1 Product Structure 44
2.9.3.2 Features and Models 44
2.9.3.3 Operation Procedures 44
2.9.4 ExoSeal Vascular Closure Device 45
2.9.4.1 Product Structure 45
2.9.4.2 Features and Models 45
2.9.4.3 Operation Procedures 45
2.9.5 Hemostat 45
2.9.5.1 Product Structure 45
2.9.5.2 Features and Models 45
2.9.5.3 Operation Procedures 46
3: Balloon Dilatation Catheter 47
3.1 Introduction 47
3.1.1 Balloon Performance 47
3.1.1.1 The Crossing Profile 47
3.1.1.2 Flexibility 47
3.1.1.3 Trackability 47
3.1.1.4 Pushability 47
3.1.2 Balloon Compliance 47
3.1.2.1 The Non-compliant Balloon 48
3.1.2.2 The Semi-compliant Balloon 48
3.1.2.3 The Compliant Balloon 48
3.1.3 Types and Features of Balloons 48
3.1.3.1 OTW 48
3.1.3.2 RX 48
3.2 OTW Balloon Dilatation Catheter 48
3.2.1 Product Structure 48
3.2.2 Specifications and Models 48
3.2.3 Brand Information 49
3.2.3.1 Mustang Balloon Dilatation Catheter 49
Product Structure 49
Features and Models 49
3.2.3.2 Admiral Xtreme Balloon Dilatation Catheter 49
Product Structure 49
Features and Models 50
3.2.3.3 Reekross 35 Balloon Dilatation Catheter 50
Product Structure 50
Features and Models 50
3.2.3.4 Savvy Long Balloon Dilatation Catheter 50
Product Structure 50
Features and Models 50
3.2.3.5 Evercross Balloon Dilatation Catheter 50
Product Structure 50
Features and Models 50
3.2.3.6 Fox Sv Balloon Dilatation Catheter 50
Product Structure 50
Features and Models 50
3.2.3.7 Passeo-35 Balloon Dilatation Catheter 51
Product Structure 51
Features and Models 51
3.2.3.8 Coda Balloon Dilatation Catheter 51
Product Structure 51
Features and Models 51
3.2.3.9 Tri-Lobe Balloon Dilatation Catheter 51
Product Structure 51
Features and Models 51
3.3 RX Balloon Dilatation Catheter 52
3.3.1 Product Structure 52
3.3.2 Specifications and Models 52
3.3.3 Brand Information 52
3.3.3.1 Sterling Monorail Balloon Dilatation Catheter 52
Product Structure 52
Features and Models 52
3.3.3.2 LitePAC Balloon Dilatation Catheter 52
Product Structure 52
Features and Models 52
3.3.3.3 Submarine Rapido Balloon Dilatation Catheter 52
Product Structure 52
Features and Models 53
3.4 Special Balloon Dilatation Catheter 53
3.4.1 Peripheral Cutting Balloon Dilatation Catheter 53
3.4.1.1 Product Structure 53
3.4.1.2 Features and Models 53
3.4.2 VascuTrak Dual-Wire Balloon Dilatation Catheter 53
3.4.2.1 Product Structure 53
3.4.2.2 Features and Models 53
3.4.3 AngioSculpt Scoring Balloon 54
3.4.3.1 Product Structure 54
3.4.3.2 Features and Models 54
3.4.4 Drug-Coated Balloon 54
4: Embolic Protection Device 56
4.1 Introduction 56
4.2 Angioguard Embolic Protection Device 56
4.2.1 Product Structure 56
4.2.2 Features and Models 56
4.3 Filterwire EZ Embolic Protection Device 57
4.3.1 Product Structure 57
4.3.2 Features and Models 57
4.4 SpiderFX Embolic Protection Device 57
4.4.1 Product Structure 57
4.4.2 Features and Models 57
4.5 Emboshield NAV6 Embolic Protection Device 57
4.5.1 Product Structure 57
4.5.2 Features and Models 58
4.6 Mo.Ma Embolic Protection Device 58
4.6.1 Product Structure 58
4.6.2 Features and Models 58
5: Peripheral Stent 59
5.1 Introduction 59
5.1.1 Classifications of Stents 59
5.1.1.1 By Stent’s Release Mode 59
Self-Expanding Stent 59
Balloon-Expandable Stent 59
5.1.1.2 By Availability of Stent Graft 59
Stent Graft 59
Bare Stent 59
5.1.1.3 By Production Process of the Stent 60
Braided Stent 60
Laser-Engraved Stent 60
5.1.1.4 By the Structure of the Engraved Cells 60
Closed-Cell Stent 60
Open-Cell Stent 60
Open- and Closed-Cell Hybrid Stent 60
5.1.1.5 By Availability with Drugs on the Stent 60
Non-drug-Eluting Stent 60
Drug-Eluting Stent 60
5.1.2 Stent Materials 60
5.1.2.1 316L Stainless Steel 60
5.1.2.2 Cobalt-Chromium Alloy 60
5.1.2.3 Nickel-Titanium Alloy 60
5.1.2.4 Degradable Polymer Materials 60
5.1.2.5 Absorbable Metal Materials 60
5.2 Self-Expanding Peripheral Stent 61
5.2.1 Product Structure 61
5.2.2 Features and Models 61
5.2.3 Brand Information 61
5.2.3.1 Complete SE Peripheral Stent 61
Product Structure 61
Features and Models 62
5.2.3.2 E-Luminexx Peripheral Stent 62
Product Structure 62
Features and Models 62
5.2.3.3 Lifestent Peripheral Stent 62
Product Structure 62
Features and Models 62
5.2.3.4 Smart Control Peripheral Stent 62
Product Structure 62
Features and Models 63
5.2.3.5 Smart Flex Peripheral Stent 63
Product Structure 63
Features and Models 63
5.2.3.6 Pulsar-18 Peripheral Stent System 63
Product Structure 63
Features and Models 63
5.2.3.7 Everflex Peripheral Stent 63
Product Structure 63
Features and Models 64
5.2.3.8 Innova Peripheral Stent 64
Product Structure 64
Features and Models 64
5.2.3.9 Wallstent Peripheral Stent 64
Product Structure 64
Features and Models 64
5.2.3.10 Absolute Pro Peripheral Stent 65
Product Structure 65
Features and Models 65
5.2.3.11 Supera Peripheral Stent 65
Product Structure 65
Features and Models 65
5.3 Self-Expanding Carotid Artery Stent 65
5.3.1 Product Structure 65
5.3.2 Features and Models 66
5.3.3 Brand Information 66
5.3.3.1 Wallstent Carotid Artery Stent 66
Product Structure 66
Features and Models 66
5.3.3.2 Acculink Carotid Artery Stent 66
Product Structure 66
Features and Models 66
5.3.3.3 Cristallo Ideale Carotid Artery Stent 67
Product Structure 67
Features and Models 67
5.3.3.4 Enterprise Revascularization Device 67
Product Structure 67
Features and Models 68
5.4 Self-Expanding Peripheral Stent Graft 68
5.4.1 Product Structure 68
5.4.2 Features and Models 68
5.4.3 Brand Information 68
5.4.3.1 Viabahn Peripheral Stent Graft 68
Product Structure 68
Features and Models 68
5.4.3.2 Fluency Peripheral Stent Graft 69
Product Structure 69
Features and Models 69
5.4.3.3 Wallgraft Peripheral Stent Graft 69
Product Structure 69
Features and Models 69
5.5 Balloon-Expandable Peripheral Stent 69
5.5.1 Product Structure 69
5.5.2 Features and Models 69
5.5.3 Brand Information 70
5.5.3.1 Hippocampus Balloon-Expandable Stent 70
Product Structure 70
Features and Models 71
5.5.3.2 Express SD Balloon-Expandable Stent 71
Product Structure 71
Features and Models 71
5.5.3.3 Palmaz Blue Balloon-Expandable Stent 71
Product Structure 71
Features and Models 71
5.5.3.4 Express LD Balloon-Expandable Stent 71
Product Structure 71
Features and Models 72
5.5.3.5 Omnilink Elite Balloon-Expandable Stent 72
Product Structure 72
Features and Models 72
5.6 Balloon-Expandable Drug-Eluting Stent 72
5.6.1 Product Structure 72
5.6.1.1 Paclitaxel, Rapamycin, and Their Derivatives 72
5.6.1.2 Everolimus 72
5.6.2 Features and Models 72
5.6.3 Brand Information 73
5.6.3.1 Xience Prime Balloon-Expandable Drug-Eluting Stent 73
Product Structure 73
Features and Models 73
5.6.3.2 Firebird2 Balloon-Expandable Drug-­Eluting Stent 73
Product Structure 73
Features and Models 73
6: Aortic Endograft 74
6.1 Introduction 74
6.2 TAA Stent Graft 74
6.2.1 Product Structure 74
6.2.2 Features and Models 74
6.2.3 Brand Information 75
6.2.3.1 Hercules TAA Stent Graft 75
Product Structure 75
Features and Models 75
6.2.3.2 Zenith TX2 TAA Stent Graft 75
Product Structure 75
Features and Models 76
6.2.3.3 Valiant TAA Stent Graft 76
Product Structure 76
Features and Models 76
6.2.3.4 C-TAG TAA Stent Graft 76
Product Specifications 76
Features and Models 76
6.2.3.5 Ankura TAA Stent Graft 77
Product Structure 77
Features and Models 77
6.2.3.6 Relay TAA Stent Graft 77
Product Structure 77
Features and Models 77
6.2.3.7 Castor TAA Stent Graft 77
Product Structure 77
Features and Models 78
6.3 AAA Stent Graft 78
6.3.1 Product Structure 78
6.3.2 Features and Models 78
6.3.3 Brand Information 79
6.3.3.1 Aegis AAA Stent Graft 79
Product Structure 79
Features and Models 79
6.3.3.2 Hercules AAA Stent Graft 79
Product Structure 79
Features and Models 79
6.3.3.3 Zenith Flex AAA Stent Graft 79
Product Structure 79
Features and Models 80
6.3.3.4 Endurant AAA Stent Graft 80
Product Structure 80
Features and Models 80
6.3.3.5 Excluder AAA Endoprosthesis 80
Product Structure 80
Features and Models 81
6.3.3.6 Ankura AAA Stent Graft 81
Product Structure 81
Features and Models 81
6.3.3.7 Incraft AAA Stent Graft 81
Product Structure 81
Features and Models 81
6.4 CP Stent 82
6.4.1 Product Structure 82
6.4.2 Features and Models 82
7: Cardiac Aortic Valved Stent 83
7.1 Introduction 83
7.2 Sapien XT Balloon-Expandable Valved Stent 84
7.2.1 Product Structure 84
7.2.2 Features and Models 84
7.3 Core Valve Self-Expanding Valved Stent 84
7.3.1 Product Structure 84
7.3.2 Features and Models 85
7.4 Venus A Self-Expanding Valved Stent 85
7.4.1 Product Structure 85
7.4.2 Features and Models 85
7.5 J-Valve Self-Expanding Valved Stent 85
7.5.1 Product Structure 85
7.5.2 Features and Models 86
8: Vena Cava Filter 87
8.1 Introduction 87
8.2 Tempofilter II Vena Cava Filter 87
8.2.1 Product Structure 87
8.2.2 Features and Models 88
8.3 VenaTech Convertible Vena Cava Filter 88
8.3.1 Product Structure 88
8.3.2 Features and Models 88
8.4 Denali Vena Cava Filter 88
8.4.1 Product Structure 88
8.4.2 Features and Models 89
8.5 Optease Vena Cava Filter 89
8.5.1 Product Structure 89
8.5.2 Features and Models 89
8.6 Aegisy Vena Cava Filter 89
8.6.1 Product Structure 89
8.6.2 Features and Models 90
8.7 Celect Vena Cava Filter 90
8.7.1 Product Structure 90
8.7.2 Features and Models 90
8.8 Option Vena Cava Filter 91
8.8.1 Product Structure 91
8.8.2 Features and Models 91
9: Vascular Prosthesis 92
9.1 Introduction 92
9.1.1 Materials of Vascular Prosthesis 92
9.1.1.1 Dacron 92
9.1.1.2 ePTFE 92
9.1.1.3 PU 92
9.1.2 Characteristics of Vascular Prosthesis 93
9.2 Gore-Tex Vascular Prosthesis 93
9.2.1 Product Structure 93
9.2.2 Features and Models 93
9.3 Impra Vascular Prosthesis 94
9.3.1 Product Structure 94
9.3.2 Features and Models 94
10: Other Endovascular Devices 95
10.1 Aspiration Thrombectomy System 95
10.1.1 Product Structure 95
10.1.2 Features and Models 96
10.1.3 Operation Procedures 96
10.1.3.1 Prepare the Console 96
10.1.3.2 Load the Catheter 96
10.1.3.3 Aspiration Mode 96
10.1.3.4 Thrombolysis Mode 96
10.2 Mechanical Thrombectomy System 96
10.2.1 Product Structure 96
10.2.2 Features and Models 97
10.3 Peripheral Plaque Excision System 98
10.3.1 Product Structure 98
10.3.2 Features and Models 98
10.4 Reentry Catheter 98
10.4.1 Outback Reentry Catheter 98
10.4.1.1 Product Structure 98
10.4.1.2 Features and Models 98
10.4.2 OffRoad Reentry Catheter 98
10.4.2.1 Product Structure 98
10.4.2.2 Features and Models 99
10.5 Embolization 99
10.5.1 Cook Embolization 99
10.5.1.1 Product Structure 99
10.5.1.2 Features and Models 99
10.5.2 Interlock Embolization 99
10.5.2.1 Product Structure 99
10.5.2.2 Features and Models 100
10.5.3 Jasper Embolization 100
10.5.3.1 Product Structure 100
10.5.3.2 Features and Models 100
10.6 Liquid Embolic System 100
10.6.1 Onyx Liquid Embolic System 100
10.6.1.1 Product Structure 100
10.6.1.2 Features and Models 101
10.6.2 Human Fibrin Sealant 101
10.6.2.1 Product Structure 101
10.6.2.2 Features and Models 101
10.7 Snare 101
10.7.1 Single-Loop Snare 101
10.7.1.1 Product Structure 101
10.7.1.2 Features and Models 101
10.7.2 Three-Loop Snare 101
10.7.2.1 Product Structure 101
10.7.2.2 Features and Models 101
10.8 Cerebrospinal Fluid (CSF) Drainage Kit 102
10.8.1 Product Structure 102
10.8.2 Features and Models 102
10.9 Turbo Elite Laser Fiber-Optic Catheter System 103
10.9.1 Product Structure 103
10.9.2 Features and Models 104
10.10 Memory ASDO (Atrial Septal Defect Occluder) 104
10.10.1 Product Structure 104
10.10.2 Features and Models 104
Part II: Application of Endovascular Surgery and Devices 105
11: Angiography 106
11.1 Introduction 106
11.1.1 Indications for Angiography 106
11.1.2 Contraindications for Angiography 106
11.1.3 Preoperative Preparation of Angiography 106
11.1.3.1 Physicians Who Perform the Angiography Should 106
11.1.3.2 Preparation of Patients 107
11.1.4 Angiographic Puncture Technique 107
11.2 Arteriopuncture 107
11.2.1 Puncture Site 107
11.2.1.1 Common Femoral Artery Puncture 107
11.2.1.2 Brachial Artery Puncture 107
11.2.1.3 Popliteal Artery Puncture 108
11.2.1.4 Infra-popliteal Distal Vascular Puncture 108
11.2.1.5 Special Artery Puncture 109
11.2.2 Puncture and Catheterization Methods 109
11.3 Venepuncture Technique 110
11.3.1 Percutaneous Venepuncture Technique 110
11.3.1.1 Puncture Site 110
Femoral Venepuncture 110
Jugular Venepuncture 111
11.3.1.2 Popliteal Venepuncture 111
11.3.1.3 Venepuncture and Catheterization Methods (with Femoral Venepuncture as an Example) 112
11.3.2 Anterograde Puncture Technique for Veins of Lower Extremity 112
11.3.2.1 Body Position 112
11.3.2.2 Selection of Puncture Needles 112
11.3.2.3 Selection of Insertion Angle 113
11.3.2.4 Method for Securing Puncture Needle 113
References 113
12: Cardiac Aortic Valve Stenosis 114
12.1 Introduction 114
12.2 Clinical Manifestations 115
12.2.1 Angina Pectoris 115
12.2.2 Vertigo or Syncope 115
12.2.3 Dyspnea 115
12.2.4 Hidrosis and Palpitation 115
12.2.5 Sudden Death 115
12.3 Intraoperative Coordination 115
12.3.1 Anesthesia and Surgical Position 115
12.3.2 Preparation of Items and Instruments 115
12.3.3 Preparation of Devices 115
12.3.4 Procedures and Intraoperative Coordination Process 115
12.4 Key for Intraoperative Observation 118
12.4.1 Observation of Vital Signs 118
12.4.2 Intraoperative Monitoring of Active Coagulation Time (ACT) 118
12.4.3 Observation of Puncture Site 118
References 118
13: Arteriectasia 119
13.1 Aortic Dissection 119
13.1.1 Introduction 119
13.1.2 Clinical Manifestations 120
13.1.3 Intraoperative Coordination 120
13.1.3.1 Intraoperative Coordination for Minimally Invasive Endovascular Aortic Dissection Therapy by TAA Stent Graft 120
Anesthesia and Surgical Position 120
Preparation of Routine Items and Instruments 120
Preparation of Devices 120
Selection of Minimally Invasive Endovascular Surgery 121
Procedures and Intraoperative Coordination Process 121
13.1.3.2 Intraoperative Coordination for Minimally Invasive Endovascular Surgery of Aortic Dissection with Multilayer Self-Expanding Bare Stent [2] 124
Anesthesia and Surgical Position 124
Preparation of Routine Items 124
Preparation of Devices 124
Procedures and Intraoperative Coordination Process 124
13.1.4 Key for Intraoperative Observation 125
13.1.4.1 Observe Blood Pressure 125
13.1.4.2 Observe Renal Function 126
13.1.4.3 Observe the Puncture Site 126
13.1.4.4 Observe Peripheral Artery Blood Supply 126
13.2 Abdominal Aortic Aneurysm 126
13.2.1 Introduction 126
13.2.2 Clinical Manifestations 126
13.2.2.1 Pain 127
13.2.2.2 Shock 127
13.2.2.3 Other Serious Complications 127
13.2.3 Intraoperative Coordination 127
13.2.3.1 Intraoperative Coordination for AAA Repair with Integrated Abdominal Aortic Stent 127
Anesthesia and Surgical Position 127
Preparation of Routine Items and Instruments 127
Preparation of Devices 127
Procedures and Intraoperative Coordination Process 127
13.2.3.2 Intraoperative Coordination for AAA Repair with Bifurcated Abdominal Aortic Stent 129
Anesthesia and Surgical Position 129
Preparation of Routine Items and Instruments 129
Preparation of Devices 129
Selection of Minimally Invasive Endovascular Surgery 130
Procedures and Intraoperative Coordination Process 131
13.2.3.3 Intraoperative Coordination for AAA Repair with Multilayer Self-Expanding Bare Stent 133
Anesthesia and Surgical Position 133
Preparation Routine Items and Instruments 133
Preparation of Devices 133
Procedures and Intraoperative Coordination Process 133
13.2.4 Key for Intraoperative Observation 133
13.2.4.1 Observe the Blood Supply of Lower Extremities 133
13.2.4.2 Observe Renal Function 133
13.2.4.3 Observe Intestinal Blood Supply 134
13.3 Extracranial Carotid Artery Aneurysms 134
13.3.1 Introduction 134
13.3.2 Clinical Manifestations 134
13.3.3 Intraoperative Coordination 134
13.3.3.1 Anesthesia and Surgical Position 134
13.3.3.2 Preparation of Routine Items and Instruments 134
13.3.3.3 Preparation of Devices 134
13.3.3.4 Selection of Minimally Invasive Endovascular Surgery 135
13.3.3.5 Procedures and Intraoperative Coordination Process 135
13.3.4 Key for Intraoperative Observation 135
13.3.4.1 Rehemorrhagia Due to Ruptured ECAA 135
13.3.4.2 Artery Vasospasm 137
13.3.4.3 Thrombogenesis and Intracranial Arterial Embolization 137
13.3.4.4 Stent and Coil Displacement 137
13.4 Renal Artery Aneurysm 137
13.4.1 Introduction 137
13.4.2 Clinical Manifestations 137
13.4.2.1 Hypertension 137
13.4.2.2 Hematuria 138
13.4.2.3 Renal Infarction 138
13.4.3 Intraoperative Coordination 138
13.4.3.1 Anesthesia and Surgical Position 138
13.4.3.2 Preparation of Routine Items and Instruments 138
13.4.3.3 Preparation of Devices 138
13.4.3.4 Selection of Minimally Invasive Endovascular Surgery 138
13.4.3.5 Procedures and Intraoperative Coordination Process 138
13.4.4 Key for Intraoperative Observation 138
13.4.4.1 Monitor Vital Signs 138
13.4.4.2 Observe Puncture Site 138
13.4.4.3 Observe Complications 138
13.5 Splenic Artery Aneurysm 140
13.5.1 Introduction 140
13.5.2 Clinical Manifestations 140
13.5.3 Intraoperative Coordination 140
13.5.3.1 Anesthesia and Surgical Position 140
13.5.3.2 Preparation of Routine Items and Instruments 140
13.5.3.3 Preparation of Devices 140
13.5.3.4 Selection of Minimally Invasive Endovascular Surgery 140
13.5.3.5 Procedures and Intraoperative Coordination Process 141
13.5.4 Key for Intraoperative Observation 142
13.5.4.1 Observation of Vital Signs 142
13.5.4.2 Observe Abdominal Pain 142
13.5.4.3 Observe the Puncture Site 142
13.6 Iliac Artery Aneurysm 142
13.6.1 Introduction 142
13.6.2 Clinical Manifestations 142
13.6.3 Intraoperative Coordination 143
13.6.3.1 Anesthesia and Surgical Position 143
13.6.3.2 Preparation of Routine Items and Instruments 143
13.6.3.3 Preparation of Devices 143
13.6.3.4 Selection of Minimally Invasive Endovascular Surgery 143
13.6.3.5 Procedures and Intraoperative Coordination Process 144
13.6.4 Key for Intraoperative Observation 144
13.6.4.1 Observe the Puncture Site 144
13.6.4.2 Observe the Patient’s Blood Supply 145
13.6.4.3 Observe Endoleak 145
References 145
14: Artery Occlusive Diseases 146
14.1 Carotid Artery Stenosis 146
14.1.1 Introduction 146
14.1.2 Clinical Manifestations 147
14.1.2.1 Symptomatic Carotid Artery Stenosis 147
14.1.2.2 Asymptomatic Carotid Artery Stenosis 147
14.1.3 Intraoperative Coordination 147
14.1.3.1 Anesthesia and Surgical Position 147
14.1.3.2 Preparation of Items 147
14.1.3.3 Preparation of Devices 147
14.1.3.4 Selection of Minimally Invasive Endovascular Surgery 148
14.1.3.5 Procedures and Intraoperative Coordination Process 148
14.1.4 Essentials for Intraoperative Observation 149
14.1.4.1 Observe Carotid Sinus Reaction 149
14.1.4.2 Observe Hyperperfusion Syndrome 149
14.2 Subclavian Artery Stenosis 149
14.2.1 Introduction 149
14.2.2 Clinical Manifestations 150
14.2.2.1 Blood Pressure 150
14.2.2.2 Pulse 150
14.2.2.3 Limb Hypofunction and Neurological Symptoms 150
14.2.3 Intraoperative Coordination 150
14.2.3.1 Anesthesia and Surgical Position 150
14.2.3.2 Preparation of Items 150
14.2.3.3 Preparation of Devices 150
14.2.3.4 Selection of Minimally Invasive Endovascular Surgery 151
14.2.3.5 Procedures and Intraoperative Coordination Process 151
14.2.4 Essentials for Intraoperative Observation 151
14.2.4.1 Observe Vital Signs 151
14.2.4.2 Observe Neurological Symptoms 152
14.3 Renal Artery Stenosis 152
14.3.1 Introduction 152
14.3.2 Clinical Manifestations 152
14.3.2.1 Characteristics of Case History 152
14.3.2.2 Symptoms and Signs 152
14.3.3 Intraoperative Coordination 153
14.3.3.1 Anesthesia and Surgical Position 153
14.3.3.2 Preparation of Items 153
14.3.3.3 Preparation of Devices 153
14.3.3.4 Selection of Minimally Invasive Endovascular Surgery 153
14.3.3.5 Procedures and Intraoperative Coordination Process 153
14.3.4 Essentials for Intraoperative Observation 153
14.3.4.1 Monitor Blood Pressure 153
14.3.4.2 Observe Complications 153
14.4 Lower Extremity Arteriosclerosis Obliterans 155
14.4.1 Introduction 155
14.4.2 Clinical Manifestations 155
14.4.2.1 Fontaine Staging System 155
14.4.2.2 Rutherford Classification 155
14.4.3 Intraoperative Coordination 156
14.4.3.1 Anesthesia and Surgical Position 156
14.4.3.2 Preparation of Items 156
14.4.3.3 Preparation of Devices 156
14.4.3.4 Selection of Minimally Invasive Endovascular Surgery 156
14.4.3.5 Procedures and Intraoperative Coordination Process 157
14.4.4 Essentials for Intraoperative Observation 157
14.4.4.1 Observe Vital Signs 157
14.4.4.2 Observe Pains 159
References 159
15: Superficial Varicosis of Lower Extremity 160
15.1 Introduction 160
15.2 Clinical Manifestations 160
15.3 Intraoperative Coordination 161
15.3.1 Anesthesia and Surgical Position 161
15.3.2 Preparation of Items 161
15.3.3 Selection of Minimally Invasive Endovascular Surgery 161
15.3.4 Procedures and Intraoperative Coordination Process 161
15.4 Essentials for Intraoperative Observation 162
15.4.1 Observe Vital Signs 162
15.4.2 Observe Bleeding 162
Reference 162
16: Veno-occlusive Disease 163
16.1 Deep Venous Thrombosis of Lower Extremity 163
16.1.1 Introduction 163
16.1.2 Clinical Manifestations 163
16.1.3 Intraoperative Coordination 164
16.1.3.1 Anesthesia and Surgical Position 164
16.1.3.2 Preparation of Items 164
16.1.3.3 Preparation of Devices 164
16.1.3.4 Selection of Minimally Invasive Endovascular Surgery 164
16.1.3.5 Conventional Procedures and Intraoperative Coordination Process 165
16.1.4 Essentials for Intraoperative Observation 166
16.1.4.1 Observe Vital Signs 166
16.1.4.2 Observe Pulmonary Embolism 166
16.1.4.3 Observe Bleeding 166
16.2 Budd-Chiari Syndrome 166
16.2.1 Introduction 166
16.2.2 Clinical Manifestations 167
16.2.3 Intraoperative Coordination 167
16.2.3.1 Anesthesia and Surgical Position 167
16.2.3.2 Preparation of Items 167
16.2.3.3 Preparation of Devices 167
16.2.3.4 Selection of Minimally Invasive Endovascular Surgery 167
16.2.3.5 Procedures and Intraoperative Coordination Process 168
16.2.4 Essentials for Intraoperative Observation 168
16.2.4.1 Cardiac Failure 168
16.2.4.2 Hemorrhage 169
16.2.4.3 Pulmonary Embolism 169
References 169
17: Arteriovenous Fistula 170
17.1 Introduction 170
17.2 Clinical Manifestations 171
17.2.1 Murmur and Tremor Present in Fistula Area 171
17.2.2 Pulse Rate Increased 171
17.2.3 Cardiac Enlargement and Heart Failure 171
17.2.4 Local Temperature Rise 171
17.2.5 Venous Insufficiency 171
17.3 Intraoperative Coordination 171
17.3.1 Anesthesia and Surgical Position 171
17.3.2 Preparation of Items 171
17.3.3 Preparation of Devices 171
17.3.4 Selection of Minimally Invasive Endovascular Surgery 172
17.3.5 Procedures and Intraoperative Coordination Process 172
17.4 Essentials for Intraoperative Observation 174
17.4.1 Pulmonary Embolism 174
17.4.2 Post-embolization Distal Ischemia and Venous Thrombosis 174
References 174
18: Endovascular Operation-Related Complications and Treatment 175
18.1 Vascular Puncture-Related Complications and Treatment 175
18.1.1 Puncture Site Bleeding and Hematoma 175
18.1.1.1 Causes 176
18.1.1.2 Prevention 176
18.1.1.3 Treatment 176
18.1.2 Pseudoaneurysm 177
18.1.2.1 Causes 177
18.1.2.2 Prevention 177
18.1.2.3 Treatment 177
18.1.3 Arteriovenous Fistula 177
18.1.3.1 Causes 177
18.1.3.2 Prevention 177
18.1.3.3 Treatment 177
18.1.4 Acute Arterial Thrombosis in Limbs 178
18.1.4.1 Causes 178
18.1.4.2 Prevention 178
18.1.4.3 Treatment 178
18.1.5 Osteofascial Compartment Syndrome 178
18.1.5.1 Causes 178
18.1.5.2 Prevention 178
18.1.5.3 Treatment 178
18.1.6 Puncture Site Infection 178
18.1.6.1 Causes 179
18.1.6.2 Prevention 179
18.1.6.3 Treatment 179
18.2 Wire- and Catheter-Related Complications and Treatment 179
18.2.1 Arterial Perforation 179
18.2.1.1 Causes 179
18.2.1.2 Prevention 179
18.2.1.3 Treatment 179
18.2.2 Artery Dissection 179
18.2.2.1 Causes 179
18.2.2.2 Prevention 179
18.2.2.3 Treatment 180
18.2.3 Device Rupture or Embolism 180
18.3 Balloon- and Stent-Related Complications and Treatment 180
18.3.1 Arterial Embolism 180
18.3.1.1 Causes 180
18.3.1.2 Prevention 180
18.3.1.3 Treatment 180
18.3.2 Arteriorrhexis 181
18.3.2.1 Causes 181
18.3.2.2 Prevention 181
18.3.2.3 Treatment 181
18.3.3 Arteriospasm and Lateral Branch Occlusion 181
18.3.3.1 Causes 181
18.3.3.2 Prevention 181
18.3.3.3 Treatment 181
18.3.4 Arterial Dissection 181
18.3.4.1 Causes 181
18.3.4.2 Prevention 181
18.3.4.3 Treatment 181
References 182
19: Case Studies 183
19.1 Case 1 Chimney Graft Technique for Aortic Arch Pseudoaneurysm Repair 183
19.1.1 Patient Data 183
19.1.2 Surgical Operation 183
19.1.3 Device Preparation 183
19.1.4 Procedures and Intraoperative Coordination Process 183
19.1.5 Technical Essentials and Precautions 185
19.2 Case 2 Single-Branched Stent and Fenestration Technique for Treatment of Aortic Dissection 185
19.2.1 Patient Data 185
19.2.2 Surgical Operation 185
19.2.3 Device Preparation 186
19.2.4 Procedures and Intraoperative Coordination Process 186
19.2.5 Technical Essentials and Precautions 187
19.3 Case 3 Double-Chimney + Guglialmi Detachable Coil Embolotherapy for Endovascular Aortic Aneurysm Repair 188
19.3.1 Patient Data 188
19.3.2 Surgical Operation 188
19.3.3 Device Preparation 188
19.3.4 Procedures and Intraoperative Coordination Process 188
19.3.5 Technical Essentials and Precautions 190
19.4 Case 4 Cuff Graft Technique for Endovascular Repair of Ascending Aortic Dissection Artery Aneurysm 190
19.4.1 Patient Data 190
19.4.2 Surgical Operation 191
19.4.3 Device Preparation 191
19.4.4 Procedures and Intraoperative Coordination Process 191
19.4.5 Technical Essentials and Precautions 192
19.5 Case 5 Balloon Occlusion and Endovascular Accelerated Blood Coagulation Technique for Ruptured Abdominal Aortic Aneurysm Repair 193
19.5.1 Patient Data 193
19.5.2 Surgical Operation 193
19.5.3 Device Preparation 193
19.5.4 Procedures and Intraoperative Coordination Process 193
19.5.5 Technical Essentials and Precautions 195
19.6 Case 6 Sandwich Technique for Endovascular Repair of Abdominal Aortic Aneurysm with Iliac Artery Aneurysm 195
19.6.1 Patient Data 195
19.6.2 Surgical Operation 195
19.6.3 Device Preparation 196
19.6.4 Procedures and Intraoperative Coordination Process 196
19.6.5 Technical Essentials and Precautions 198
19.7 Case 7 Self-Expanding Bare Stent-­Assisted Spring Coil Embolotherapy for Endovascular Repair of Visceral Abdominal Aortic Pseudoaneurysm 199
19.7.1 Patient Data 199
19.7.2 Surgical Operation 199
19.7.3 Device Preparation 199
19.7.4 Procedures and Intraoperative Coordination Process 199
19.7.5 Technical Essentials and Precautions 200
19.8 Case 8 Hybrid Technique for Repair of Vertebral Artery Pseudoaneurysm Complicated with Brachial Plexus Compression 201
19.8.1 Patient Data 201
19.8.2 Surgical Operation 201
19.8.3 Device Preparation 201
19.8.4 Procedures and Intraoperative Coordination Process 201
19.8.5 Technical Essentials and Precautions 203
19.9 Case 9 Double-Protection Device Technique for Minimally Invasive Endovascular Repair of Left Carotid Subtotal Occlusive Lesion 203
19.9.1 Patient Data 203
19.9.2 Surgical Operation 204
19.9.3 Device Preparation 204
19.9.4 Procedures and Intraoperative Coordination Process 204
19.9.5 Technical Essentials and Precautions 207
19.10 Case 10 Catheter-Directed Thrombolysis and Rotarex Mechanical Aspiration Thrombectomy Technique for Treatment of Acute Superior Mesenteric Artery Embolization 208
19.10.1 Patient Data 208
19.10.2 Surgical Operation 208
19.10.3 Device Preparation 208
19.10.4 Procedures and Intraoperative Coordination Process 208
19.10.5 Technical Essentials and Precautions 210
19.11 Case 11 Coil Embolization Technique for Treatment of Giant Splenic Artery Aneurysm 211
19.11.1 Patient Data 211
19.11.2 Surgical Operation 211
19.11.3 Device Preparation 211
19.11.4 Procedures and Intraoperative Coordination Process 211
19.11.5 Technical Essentials and Precautions 213
19.12 Case 12 Coil Embolization-Assisted Abdominal Aortoiliac Stent Technique for Endovascular Repair of Iliac Artery Aneurysm 213
19.12.1 Patient Data 213
19.12.2 Surgical Operation 213
19.12.3 Device Preparation 213
19.12.4 Procedures and Intraoperative Coordination Process 213
19.12.5 Technical Essentials and Precautions 215
19.13 Case 13 Muff Coupling Technique for Lower Extremity Popliteal Aneurysm Repair 215
19.13.1 Patient Data 215
19.13.2 Surgical Operation 215
19.13.3 Device Preparation 216
19.13.4 Procedures and Intraoperative Coordination Process 216
19.13.5 Technical Essentials and Precautions 218
19.14 Case 14 Retrograde Approach with Stent Graft Technique for Treatment of Popliteal Arteriosclerosis Obliterans 218
19.14.1 Patient Data 218
19.14.2 Surgical Operation 218
19.14.3 Device Preparation 218
19.14.4 Procedures and Intraoperative Coordination Process 218
19.14.5 Technical Essentials and Precautions 223
19.15 Case 15 Direct Stent Puncture Technique for Treatment of In-Stent Restenosis of Femoropopliteal Artery 223
19.15.1 Patient Data 223
19.15.2 Surgical Operation 223
19.15.3 Device Preparation 223
19.15.4 Procedures and Intraoperative Coordination Process 223
19.15.5 Technical Essentials and Precautions 227
19.16 Case 16 Retrograde Puncture and Bionic Stent Technique for Treatment of Seriously Calcified Femoral Artery Bifurcation Lesion 228
19.16.1 Patient Data 228
19.16.2 Surgical Operation 228
19.16.3 Device Preparation 228
19.16.4 Procedures and Intraoperative Coordination Process 228
19.16.5 Technical Essentials and Precautions 233
19.17 Case 17 AngioJet Thrombus Aspiration Technique for Treatment of Acute Deep Vein Thrombosis 234
19.17.1 Patient Data 234
19.17.2 Surgical Operation 234
19.17.3 Device Preparation 234
19.17.4 Procedures and Coordination Process 234
19.17.5 Technical Essentials and Precautions 236
19.18 Case 18 Coil Embolization and Peripheral Stent Graft Technique for Treatment of Left Subclavian Arteriovenous Fistula 236
19.18.1 Patient Data 236
19.18.2 Surgical Operation 237
19.18.3 Device Preparation 237
19.18.4 Procedures and Intraoperative Coordination Process 237
19.18.5 Technical Essentials and Precautions 238
19.19 Case 19 Reinforced Bar and Concrete Technique for Treatment of Lower Extremity Arteriovenous Fistula 239
19.19.1 Patient Data 239
19.19.2 Surgical Operation 239
19.19.3 Device Preparation 239
19.19.4 Procedures and Intraoperative Coordination Process 239
19.19.5 Technical Essentials and Precautions 241
19.20 Case 20 High Ligation + Punctate Stripping + Sclerotherapy for Treatment of Great Saphenous Varicose with Superficial Thrombophlebitis 241
19.20.1 Patient Data 241
19.20.2 Surgical Operation 242
19.20.3 Device Preparation 242
19.20.4 Procedures and Intraoperative Coordination Process 242
19.20.5 Technical Essentials and Precautions 244
References 244
Part III: Management Over Endovascular Devices 245
20: Management Theories and Methods 246
20.1 Agile Supply Chain Management of Endovascular Devices 246
20.1.1 Diversity, Complexity, and Professionalism 246
20.1.2 Dynamic Change and Emergency Delivery Demand 247
20.1.3 Personalized Preference and Intelligent Recommendation 247
20.1.4 Adverse Reaction Predication and Safety Precautions 247
20.2 Autonomous Intelligent Decision-­Making for Coordinated Delivery 248
20.2.1 Device Selection Scheme Decision 249
20.2.2 Device Delivery Scheme Decision 249
References 252
21: Device Management 254
21.1 Storage Management of Endovascular Devices 254
21.1.1 Medical Consumable Storage Unit 254
21.1.2 Stent Storage Cabinet 255
21.1.3 Aortic Stent Hanging Piece 255
21.2 Information-Based Management of Endovascular Devices 256
21.2.1 Current Status of Information-Based Management of Endovascular Devices 256
21.2.2 Information-Based Management Model for High-Value Endovascular Devices 257
21.2.3 Information-Based Management System for High-Value Endovascular Devices 258
21.2.4 System Functions and Operation Procedures 258
21.3 Registration Management of Endovascular Devices 261
21.4 Management System for Using Endovascular Devices 262
21.4.1 Management System for Using Low-Value Endovascular Devices 264
21.4.2 Management System for Implantable High-Value Endovascular Devices 264
References 269
22: Personnel Management 270
22.1 Supplier Management 270
22.2 Patient Management 271
22.2.1 Emotion Management 271
22.2.2 Temperature Management 272
22.2.3 Skin Management 272
22.2.4 Safety Management 272
22.3 Neuromanagement and Smart Medical Services 272
22.4 Management of Device Platforms and Device Management Engineers 275
22.4.1 Establishing Endovascular Device Platform 275
22.4.1.1 Poor Professionalism 275
22.4.1.2 Lack of Frontier Knowledge 275
22.4.1.3 Failure to Meet Dynamic Demands 275
22.4.1.4 Delayed Information Exchange with Suppliers 275
22.4.1.5 Chaotic Device Management 275
22.4.2 Managing Professional Skills of Device Management Engineers 276
22.4.3 Professional Requirements for Device Management Engineers 276
22.4.3.1 Size of Devices 276
22.4.3.2 Models of Devices 276
22.4.3.3 Types of Devices 276
22.4.3.4 Features of Devices 276
22.4.3.5 Use of Devices 276
22.4.3.6 Development and Frontier Knowledge of Devices 276
22.4.4 Essentials for Intraoperative Coordination by Device Management Engineers 276
22.4.4.1 Planning 276
22.4.4.2 Flexibility 277
22.4.4.3 Professionalism 277
22.4.4.4 Adaptability 277
22.4.4.5 Creativity 277
22.4.4.6 Economy 277
22.5 Radiological Safety Management 277
22.5.1 Basic Requirements for Interventional Radiological Protective Articles 277
22.5.2 Use and Management of Interventional Radiological Protective Articles 278
22.5.2.1 Principles in Using Radiation-Proof Clothes and Collars 279
22.5.2.2 Management of Radiation-Proof Clothes and Collars 279
22.5.3 Common Protective Measures 280
22.5.3.1 General Protection 280
Inherent Protection of X-Ray Machine 280
Time Protection 280
Distance Protection 280
Shielding Protection 280
22.5.3.2 Patient Protection 280
22.5.3.3 Staff Protection 281
Wear Dose Detector 281
Observe Protective Regulations 281
Regularly Inspect Protection 281
Others 281
22.5.3.4 Protection of DSA Room 281
22.5.4 Healthcare System for Interventional Radiotherapy Personnel 281
22.5.4.1 Health Management 281
22.5.4.2 Items for Regular Physical Examination 281
22.5.4.3 Nutrition Healthcare for Interventional Radiotherapy Personnel 281
Special Nutritional Requirements for Interventional Radiotherapy Workers 282
Drugs and Healthcare Products Conducive to Reducing Radiation Damage 282
22.5.4.4 Health Standard for Interventional Radiotherapy Personnel 282
22.5.5 Regulations on Catheter Room X-Ray Protection Management 282
References 283