中风后下腔静脉过滤器移位至心脏:病例报告。

IF 2.2 4区 医学 Q1 REHABILITATION
Daniel A Goodman, Ellen Farr, Leslie Rydberg
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引用次数: 0

摘要

本病例报告讨论了一名因下腔静脉(IVC)滤器移位嵌入右侧心脏而并发中风导致偏瘫的患者的功能预后和多学科协调护理。患者急性右侧中风伴出血转化,需要进行左侧偏瘫的半颅切除术。患者随后出现肺栓塞,由于有进一步颅内出血的风险,禁忌抗凝治疗,因此需要置入 IVC 过滤器。后来发现 IVC 过滤器与三尖瓣桥接,手术治疗是禁忌症,因此需要协调计划,推迟手术切除过滤器,以便优化患者的功能和医疗状况。患者在重症监护室接受了广泛的遥测监测,以确认在进行体力活动时没有出现明显的心律失常,最终获准进入急性住院康复治疗。心脏科、外科、重症监护室和康复科团队通力合作,将患者转入住院康复设施,以最大限度地降低风险并促进康复。在整个康复过程中,患者的功能得到了改善,并在家人的陪伴下出院回家,最终通过手术取出了 IVC 过滤器。本病例强调了多学科合作对最大限度地提高患者康复和功能的重要性,尤其是在非典型并发症的情况下。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Inferior vena cava filter migration to the heart after stroke: a case report.

This case report discusses the functional outcomes and multidisciplinary coordination of care for a patient with hemiplegia due to stroke complicated by a migrated inferior vena cava (IVC) filter embedded in the right side of the heart. The patient suffered an acute right-sided stroke with hemorrhagic transformation requiring hemicraniectomy with left hemiplegia. The patient developed a subsequent pulmonary embolism requiring IVC filter placement as anticoagulation was contraindicated due to risk of further intracranial hemorrhage. The IVC filter was later identified bridging the tricuspid valve, and surgical intervention was contraindicated requiring a coordinated plan to delay surgical removal of the filter in order to allow for optimization of the patient's functional and medical status. The patient underwent extensive telemetry monitoring in the intensive care unit to verify no significant cardiac arrhythmia developed with physical activity and was ultimately cleared for admission to acute inpatient rehabilitation. There was a well-coordinated effort between the cardiac, surgical, intensive care, and rehabilitation teams to transition to the inpatient rehabilitation facility to minimize risk and enhance recovery. The patient demonstrated functional improvement throughout rehabilitation and was discharged home with family with eventual surgical removal of the IVC filter. This case highlights the importance of collaboration across multiple disciplines to maximize patient rehabilitation and function, particularly in the context of atypical complications.

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来源期刊
Topics in Stroke Rehabilitation
Topics in Stroke Rehabilitation 医学-康复医学
CiteScore
5.10
自引率
4.50%
发文量
57
审稿时长
6-12 weeks
期刊介绍: Topics in Stroke Rehabilitation is the leading journal devoted to the study and dissemination of interdisciplinary, evidence-based, clinical information related to stroke rehabilitation. The journal’s scope covers physical medicine and rehabilitation, neurology, neurorehabilitation, neural engineering and therapeutics, neuropsychology and cognition, optimization of the rehabilitation system, robotics and biomechanics, pain management, nursing, physical therapy, cardiopulmonary fitness, mobility, occupational therapy, speech pathology and communication. There is a particular focus on stroke recovery, improving rehabilitation outcomes, quality of life, activities of daily living, motor control, family and care givers, and community issues. The journal reviews and reports clinical practices, clinical trials, state-of-the-art concepts, and new developments in stroke research and patient care. Both primary research papers, reviews of existing literature, and invited editorials, are included. Sharply-focused, single-issue topics, and the latest in clinical research, provide in-depth knowledge.
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