| 摘要 |
<p>A system for deploying and selectively inflating a thoracic aortic balloon at a desired location within the thoracic aorta for resuscitative aortic occlusion, inferior to the left subclavian artery, without the aid of fluoroscopy is described. Using CT imaging data from a large pool of normal human subjects, a distance on each person between readily identifiable and consistently located external (i.e., bony) landmarks of torso extent is measured. Next, using the same CT imaging data, a second distance from the individual's femoral artery to a desired aortic occlusion location inferior to the left subclavian artery is determined. Using informatics and statistical modeling, a correlation between the external measure of torso extent and the desired intra-arterial (i.e. endovascular) distance within the torso is made. For the study population as a whole a nomogram is constructed. Using this nomogram, a calibrated endovascular resuscitative thoracic aortic occlusion system can be positioned to this desired location on any injured individual with end-stage shock and impending cardiovascular collapse or death without the aid of fluoroscopy for delivery or balloon inflation. Specifically, determination of the desired insertion length on any individual is provided by taking the measure of external torso extent and applying it to the nomogram. Once the desired insertion length is established, the marked or calibrated self-centering, J tipped wire is inserted through a transfemoral percutaneous sheath to the determined distance. A similarly marked shaft containing the occlusion balloon is positioned over the wire at this same desired or predetermined location prior to inflation and occlusion of the aorta. Both the endovascular wire and balloon occlusion shaft are provided with major (5 cm) and minor (1cm) calibrated markers to assure correct distance of insertion. The balloon is then inflated using a pressure-regulated technique without fluoroscopy to occlude the thoracic aorta and allow resuscitation of the patient.</p> |
