Name: a two-step method for percutaneous transhepatic choledochoscopic lithotomy
Uploaded: 2022-09-13T12:30:00
Description: Watch this Scientific Journal Video about A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy at JoVE.com

该研究得到了汕头大学医学院附属第二医院伦理委员会（中国汕头）的批准。
1. 准备工作
<ol><li>应用严格的排除标准来选择患者并获得签署的知情同意书12 （表1）。</li>
	<li>适用以下录取标准：<ol><li>选择自愿接受两步PTCSL治疗的患者。</li>
		<li>选择通过辅助检查确诊为肝和肝外胆管结石的患者。</li>
		<li>选择既往接受过复杂腹部?...

<ol>
	<li>Shu, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Robotic-assisted+laparoscopic+surgery+for+complex+hepatolithiasis:+a+propensity+score+matching+analysis.">Robotic-assisted laparoscopic surgery for complex hepatolithiasis: a propensity score matching analysis.</a> Surgical Endoscopy. 33 (8), 2539-2547 (2019).</li><li>Korkes, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Percutaneous+treatment+of+complex+biliary+stone+disease+using+endourological+technique+and+literature+review.">Percutaneous treatment of complex biliary stone disease using endourological technique and literature review.</a> Einstein. 13 (4), 611-615 (2015).</li><li>Gamal, E. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Percutaneous+video+choledochoscopic+treatment+of+retained+biliary+stones+via+dilated+t-tube+tract.">Percutaneous video choledochoscopic treatment of retained biliary stones via dilated t-tube tract.</a> Surgical Endoscopy. 15 (5), 473-476 (2001).</li><li>Khalid, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Percutaneous+endoscopic+biliary+exploration+in+complex+biliary+stone+disease:+Case+series+study.">Percutaneous endoscopic biliary exploration in complex biliary stone disease: Case series study.</a> International Journal of Surgery. 24, 73-78 (2020).</li><li>Kim, J. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Percutaneous+transhepatic+cholangioscopic+treatment+of+patients+with+benign+bilio-enteric+anastomotic+strictures.">Percutaneous transhepatic cholangioscopic treatment of patients with benign bilio-enteric anastomotic strictures.</a> Gastrointestinal Endoscopy. 58 (5), 733-738 (2003).</li><li>Hwang, J. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Risk+factors+for+recurrent+cholangitis+after+initial+hepatolithiasis+treatment.">Risk factors for recurrent cholangitis after initial hepatolithiasis treatment.</a> Journal of Clinical Gastroenterology. 38 (4), 364-367 (2004).</li><li>Bonnel, D. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Common+bile+duct+and+intrahepatic+stones:+results+of+transhepatic+electrohydraulic+lithotripsy+in+50+patients.">Common bile duct and intrahepatic stones: results of transhepatic electrohydraulic lithotripsy in 50 patients.</a> Radiology. 180 (2), 345-348 (1991).</li><li>Kondo, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+clinicopathologic+study+of+primary+cholesterol+hepatolithiasis.">A clinicopathologic study of primary cholesterol hepatolithiasis.</a> Hepato-gastroenterology. 42 (5), 478-486 (1995).</li><li>Williams, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Updated+guideline+on+the+management+of+common+bile+duct+stones+(CBDS).">Updated guideline on the management of common bile duct stones (CBDS).</a> Gut. 66 (5), 765-782 (2017).</li><li>Makuuchi, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasonically+guided+cholangiography+and+bile+drainage.">Ultrasonically guided cholangiography and bile drainage.</a> Ultrasound in Medicine &amp; Biology. 10 (5), 617-623 (1984).</li><li>Jeng, K. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Percutaneous+transhepatic+cholangioscopy+in+the+treatment+of+complicated+intrahepatic+biliary+strictures+and+hepatolithiasis+with+internal+metallic+stent.">Percutaneous transhepatic cholangioscopy in the treatment of complicated intrahepatic biliary strictures and hepatolithiasis with internal metallic stent.</a> Surgical Laparoscopy. 10 (5), 278-283 (2000).</li><li>Zhuo, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Percutaneous+transhepatic+choledochoscopic+lithotomy+(PTCSL)+is+effective+for+the+treatment+of+intrahepatic+and+extrahepatic+choledocholithiasis.">Percutaneous transhepatic choledochoscopic lithotomy (PTCSL) is effective for the treatment of intrahepatic and extrahepatic choledocholithiasis.</a> Surgical Laparoscopy, Endoscopy &amp; Percutaneous Techniques. 31 (3), 326-330 (2020).</li><li>Hazey, J. W., McCreary, M., Guy, G., Melvin, W. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+of+percutaneous+treatment+of+biliary+tract+calculi+using+the+holmium:+YAG+laser.">Efficacy of percutaneous treatment of biliary tract calculi using the holmium: YAG laser.</a> Surgical Endoscopy. 21 (7), 1180-1183 (2007).</li><li>Ozturk, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=New+surgical+technique+applied+with+urological+instruments+in+bilobar+multiple+hepatolithiasis:+Ultra-mini+percutaneous+hepatolithotomy.">New surgical technique applied with urological instruments in bilobar multiple hepatolithiasis: Ultra-mini percutaneous hepatolithotomy.</a> Turkish Journal of Urology. 43 (3), 371-377 (2017).</li><li>Ozcan, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Percutaneous+transhepatic+removal+of+bile+duct+stones:+results+of+261+patients.">Percutaneous transhepatic removal of bile duct stones: results of 261 patients.</a> Cardiovascular and Interventional Radiology. 35 (3), 621-627 (2012).</li><li>Kint, J. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Percutaneous+treatment+of+common+bile+duct+stones:+results+and+complications+in+110+consecutive+patients.">Percutaneous treatment of common bile duct stones: results and complications in 110 consecutive patients.</a> Digestive Surgery. 32 (1), 9-15 (2015).</li><li>Yeh, Y. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Percutaneous+trans-hepatic+cholangioscopy+and+lithotripsy+in+the+treatment+of+intrahepatic+stones:+a+study+with+5+year+follow-up.">Percutaneous trans-hepatic cholangioscopy and lithotripsy in the treatment of intrahepatic stones: a study with 5 year follow-up.</a> Gastrointestinal Endoscopy. 42 (1), 13-18 (1995).</li><li>Jan, Y. Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Percutaneous+trans-hepatic+cholangioscopic+lithotomy+for+hepatolithiasis:+long-term+results.">Percutaneous trans-hepatic cholangioscopic lithotomy for hepatolithiasis: long-term results.</a> Chang Gung Medical Journal. 17 (1), 149 (1994).</li><li>Cheon, Y. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+long-term+results+and+recurrent+factors+after+operative+and+nonoperative+treatment+for+hepatolithiasis.">Evaluation of long-term results and recurrent factors after operative and nonoperative treatment for hepatolithiasis.</a> Surgery. 146 (5), 843-853 (2009).</li><li>Tsutsumi, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+comparative+evaluation+of+treatment+methods+for+bile+duct+stones+after+hepaticojejunostomy+between+percutaneous+transhepatic+cholangioscopy+and+peroral,+short+double-balloon+enteroscopy.">A comparative evaluation of treatment methods for bile duct stones after hepaticojejunostomy between percutaneous transhepatic cholangioscopy and peroral, short double-balloon enteroscopy.</a> Therapeutic Advances in Gastroenterology. 10 (1), 54-67 (2017).</li></ol>

肝内和肝外胆总管结石会导致胆道梗阻，相关的胆管炎可导致革兰阴性内毒素血症，伴有脓毒性休克或多器官功能障碍的临床表现。因此，胆结石代表了一种复杂的疾病，对外科医生来说可能具有挑战性，特别是对于以前做过复杂腹部手术的患者或解剖结构异常的患者。PTCSL在世界各地被广泛使用，但仍需要创新的，侵入性较小的程序来根除结石并恢复畅通无阻的胆道引流14。</p...

肝内和肝外胆总管结石是外科医生面临的一个复杂的医学问题，在东亚国家非常普遍1。目前，大多数胆总管结石需要手术干预，而胆管结石的主要治疗方法包括开放手术、经皮经肝胆总管镜截石术（PTCSL）、腹腔镜截石术2、经皮内镜胆道探查术3，4和内镜逆行胰胆管造影术。然而，胆肠吻合术或Billroth II重建的患者，解剖结构异常，例如十二指肠壶腹周围憩室，这使得胆管难以通过内窥镜方法进入5，6，7，8，或者以前做过复杂的腹部手术，包括部分胃切除术，不能接受内窥镜治疗或腹腔镜截石术。内镜治疗也可能不适用于大结石和嵌塞结石的肝结石。因此，一般来说，PTCSL可能是更好的选择9。
传统的PTCS方法遵循这样的程序，逐渐扩张鼻窦并进行经皮经肝胆道引流10，11，这需要相对较长的住院周期，通常在2-3周之间，导致胆瘘，胆道感染，出血和腹膜炎的可能性，并具有多种扩张的鞘大小。该程序由两部分组成。第一步，刺穿目标胆管，在观察胆汁流出的同时插入导丝。然后，使用扩张器沿导丝缓慢扩展通道。通道建立成功后，拔出扩张器，将引流管放入目标胆管，然后拉出导丝。
如果胆汁引流畅通且引流固定且无血液流出，则经皮肝穿刺引流 （PTCD） 完成。PTCD 后 1 周窦道变得稳定，然后可以扩张。将导丝放入引流管中，并用10F扩张器沿导丝通过窦道膨胀，最后放入10F引流管中。手术后窦道每周扩张一次，每次增加2F尺寸，以便在PTCD后4周将窦道扩张到16F。在第二步中，将窦道扩张到16F后，使用胆道纤维镜片进行去除结石的手术。因此，上述传统的PTCSL需要一个治疗周期，并给患者带来很高的经济压力。而且，取石效率低，复方多次手术去除结石也是传统PTCS不可避免的缺点，限制了该技术的使用。
从2013年1月开始，我们开始将PTCS应用于我院复杂肝内和肝外胆总管结石患者的微创治疗，但修改了传统PTCS的一些关键步骤。第一步，在PTCD后1周进行手术，正好在窦道稳定时，使用16F扩张器将鼻窦直接扩张到16F，大大减少了术前准备时间。第二步，与传统技术不同，使用沃尔夫肾镜代替传统的胆总管镜进行手术，我们称之为“两步PTCSL法”。为了确定PTCSL手术是否安全、微创和高效，本研究回顾性回顾了2013年1月至2020年1月接受两步PTCSL方法治疗的81例肝内和肝外胆总管结石患者。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>0.9% Normal saline solution</td>
			<td></td>
			<td>-</td>
			<td></td>
		</tr>
		<tr>
			<td>16-F series fascia dilator</td>
			<td></td>
			<td>type PLVW, Cook Medical</td>
			<td></td>
		</tr>
		<tr>
			<td>adjustable pressure pump</td>
			<td></td>
			<td>type APL; Guangzhou Jielun Medical Equipment Co. , Ltd, Guangdong Province, China</td>
			<td></td>
		</tr>
		<tr>
			<td>biliary balloon dilator</td>
			<td></td>
			<td>ATB advance; Cook Medical</td>
			<td></td>
		</tr>
		<tr>
			<td>blade</td>
			<td></td>
			<td>-</td>
			<td></td>
		</tr>
		<tr>
			<td>camera system</td>
			<td></td>
			<td>1088i HD Camera Control Unit, PAL 220 V; Stryker Corporation</td>
			<td></td>
		</tr>
		<tr>
			<td>Cavity mirror protective sleeve</td>
			<td></td>
			<td>-</td>
			<td></td>
		</tr>
		<tr>
			<td>clamp</td>
			<td></td>
			<td>5Fr, Richard Wolf GmbH, Germany</td>
			<td></td>
		</tr>
		<tr>
			<td>color ultrasound machine</td>
			<td></td>
			<td>DC-N2S, Mindray</td>
			<td></td>
		</tr>
		<tr>
			<td>Cook net basket</td>
			<td></td>
			<td>NGE-017115-MB, COOK Medical Inc. , Bloomington, USA</td>
			<td></td>
		</tr>
		<tr>
			<td>drainage pack</td>
			<td></td>
			<td>-</td>
			<td></td>
		</tr>
		<tr>
			<td>expander</td>
			<td></td>
			<td>-</td>
			<td></td>
		</tr>
		<tr>
			<td>guide wire</td>
			<td></td>
			<td>-</td>
			<td></td>
		</tr>
		<tr>
			<td>hydroelectric lithotripter</td>
			<td></td>
			<td>Aymed Medical, <img alt="Equation 1" src="/files/ftp_upload/63206/63206eq01.jpg" style="margin: auto;" />stanbul, Turkey</td>
			<td></td>
		</tr>
		<tr>
			<td>&#160;Iodophor</td>
			<td></td>
			<td>-</td>
			<td></td>
		</tr>
		<tr>
			<td>&#160;Kidney basin</td>
			<td></td>
			<td>-</td>
			<td></td>
		</tr>
		<tr>
			<td>light source</td>
			<td></td>
			<td>Voice-control compatible X8000 Xenon Light Source of 300 W;Stryker Corporation, MI</td>
			<td></td>
		</tr>
		<tr>
			<td>Medical syringe</td>
			<td></td>
			<td>-</td>
			<td></td>
		</tr>
		<tr>
			<td>puncture needle</td>
			<td></td>
			<td>-</td>
			<td></td>
		</tr>
		<tr>
			<td>suction apparatus</td>
			<td></td>
			<td>-</td>
			<td></td>
		</tr>
		<tr>
			<td>surgical gauze</td>
			<td></td>
			<td>-</td>
			<td></td>
		</tr>
		<tr>
			<td>trocar</td>
			<td></td>
			<td>-</td>
			<td></td>
		</tr>
		<tr>
			<td>Wolf nephroscope</td>
			<td></td>
			<td>12-degree Ultra-Wide-Angle Ureteroreno-scope; Richard Wolf GmbH, Germany</td>
			<td></td>
		</tr>
		<tr>
			<td>zebra guide wire</td>
			<td></td>
			<td>type HAW; Cook Medical, Bloomington, IN</td>
			<td></td>
		</tr>
	</tbody>
</table>

a two-step method for percutaneous transhepatic choledochoscopic lithotomy

肝内和肝外胆总管结石是胆道外科领域的一个挑战。我们介绍了使用两步经皮经肝胆总管镜截石术（PTCSL）手术治疗具有挑战性的胆结石的经验。我们回顾性评价了2013年1月至2020年1月使用这种两步PTCSL治疗的81例肝内和肝外胆总管结石患者，包括40名男性和41名女性，平均年龄为66岁。与传统的经皮经肝胆管镜检查（PTCS）相比，直接通过16F Amplatz鞘建立通道，并借助肾镜去除通道中的结石。分析所有患者的临床疗效及并发症。81例患者（81/81，100%）胆结石成功切除;62/81患者（76.5%）在首次手术后完全切除了胆结石;17/81患者（21%）接受了第二次手术;2/81患者（2.5%）需要第三次手术才能完全去除结石。手术期间严重出血发生率为0%，无死亡病例。使用两步PTCSL方法安全有效，有助于改善肝内和肝外胆总管结石的预后。

所有患者胆道结石均成功清除，58例患者（58/81，72%）在第一次手术后完全切除胆管结石，18例患者（18/81，22%）需要第二次手术，5例患者（5/81，6%）接受第三次手术以完全清除结石。3例患者术后5年和6年复发性肝内胆石症。有56例患者（56/81，68.7%）接受了经皮肝手术，25例患者（25/81，31.3%）通过留置由“T”管形成的鼻窦接受了手术。
结石数等于每70例患者中?...

Watch this Scientific Journal Video about A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy at JoVE.com

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

这种“两步法”显著提高了经皮经肝胆总管镜检查的成功率，使肝内和肝外胆总管结石的预后更好。

经皮经肝胆胆镜截石术的两步法

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该方案显着提高了经皮经肝胆总管镜检查的成功率，并实现了更好的肝内和肝外胆总管结石的预后。该技术可减少肝内和肝外胆总管结石的复发，缩短整个碎石期、手术时间以及皮肤入口部位与靶向胆管之间的距离。PTCSL 是治疗复杂肝内和肝外胆总管结石的更好选择，例如既往接受过复杂腹部手术或解剖异常且无法接受内镜检查的患者。该技术也可用于经皮肾镜取石术以治疗肾结石问题。肝内胆管结构复杂，容易受伤，增加了手术风险，目视演示可以更好地避免这些危险的并发症。手术前一周，进行经皮经肝胆管引流术或PTCD。插入留置 8F 胆道引流管以引流并减少胆管肿胀。等待窦道在手术后一周变得稳定。沿引流管将20毫升生理盐水注入胆管。将导丝插入其中后，拉出PTCD管。要将筋膜扩张器置于鞘中，请使用 16F 扩张器扩张鼻窦并连接 16F 腰带扩张器，以便 16F 鞘可以到达可能放置结石的胆管。找到结石。使用夹钳打破并去除结石。使用可调节的压力泵洗掉小石头和粉末状石头。在手术结束时，将引流管留在患者体内一周。使用PTCSL时，所有患者的胆道结石均成功清除。72%的患者在第一次手术后完全切除了胆管结石，而28%的患者需要多次手术。56例患者接受经皮肝手术，25例患者通过留置由T管形成的鼻窦进行手术。结石数量等于每70名患者中就有一名。平均住院时间为11天。有少量反应性胸腔积液的并发症。2例患者术中小出血，1例术后胆道感染。然而，没有观察到胆道大量出血。术前超声准确定位结石位置，保留8F引流管，使用16F扩张器直接扩张鼻窦。

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医学

Preparation and Respirometric Assessment of Mitochondria Isolated from Skeletal Muscle Tissue Obtained by Percutaneous Needle Biopsy

线粒体的制备及透气性评估，从骨骼肌组织通过穿刺活检获得的分离

Respirometric profiling of isolated mitochondria is commonly used to investigate electron transport chain function. We describe a method for obtaining ...

In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses

In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses

在体内 ，经皮，基于针，肾群众的光学相干断层扫描

Optical coherence tomography (OCT) is the optical equivalent of ultrasound imaging, based on the backscattering of near infrared light. OCT provides real ...

Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver

Percutaneous Hepatic Perfusion PHP with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver

经皮肝脏灌注（PHP）与美法仑作为囿于肝脏不能手术切除转移的治疗

Unresectable liver metastases of colorectal cancer can be treated with systemic chemotherapy, aiming to limit the disease, extend survival or turn ...

Percutaneous Contrast Echocardiography-guided Intramyocardial Injection and Cell Delivery in a Large Preclinical Model

经皮超声心动图引导心肌注射液与大鼠前体细胞的临床研究

Cell and gene therapy are exciting and promising strategies for the purpose of cardiac regeneration in the setting of heart failure with reduced ejection ...

Three-Dimensional Printing Guide Template Assisted Percutaneous Vertebroplasty (PVP)

Three-Dimensional Printing Guide Template Assisted Percutaneous Vertebroplasty PVP

三维打印指南模板辅助皮椎间盘（PVP）

Percutaneous vertebroplasty (PVP) is considered an effective treatment for the back pain caused by osteoporotic vertebral compression fracture. The ...

Novel Percutaneous Approach for Deployment of 3D Printed Coronary Stenosis Implants in Swine Models of Ischemic Heart Disease

在缺血性心脏病的猪模型中部署3D打印冠状动脉狭窄植入物的新颖的皮下方法

Minimally invasive methods for creating models of focal coronary narrowing in large animals are challenging. Rapid prototyping using three-dimensionally ...

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

皮下三瓣阀修复期间回声导的简化步进方法

Percutaneous transcatheter edge-to-edge reconstruction of the mitral valve is a safe and well-established therapy for severe symptomatic mitral ...

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

经皮心室辅助装置治疗急性心肌梗死并发心源性休克

Cardiogenic shock is defined as persistent hypotension, accompanied by evidence of end organ hypo-perfusion. Percutaneous ventricular assist devices ...

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock

使用经皮心室辅助装置/左心房至股动脉旁路系统治疗心源性休克

The left atrial to femoral artery bypass (LAFAB) system is a mechanical circulatory support (MCS) device used in cardiogenic shock (CS) that bypasses the ...