桡动脉(非)常规并发症的远端解决方案:病例报告。

IF 0.8 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
European Heart Journal: Case Reports Pub Date : 2024-10-23 eCollection Date: 2024-11-01 DOI:10.1093/ehjcr/ytae564
Giuseppe Colletti, Gregory Angelo Sgueglia, Olivier Gach, Alexandre Natalis, Claudiu Ungureanu
{"title":"桡动脉(非)常规并发症的远端解决方案:病例报告。","authors":"Giuseppe Colletti, Gregory Angelo Sgueglia, Olivier Gach, Alexandre Natalis, Claudiu Ungureanu","doi":"10.1093/ehjcr/ytae564","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The European Society of Cardiology guidelines recommend transradial access (TRA) for coronary angiography due to its advantages, including lower mortality and bleeding complications. Arterial pseudoaneurysms are rare but challenging complications of TRA, occurring in 0.009%-0.05% of procedures. Non-surgical management, especially in cases with large (>1 mm) necks or late discovery, can be difficult due to the limited effectiveness of echo-guided compression and risks of echo-guided thrombin injection, like thrombin embolization leading to necrosis.</p><p><strong>Case summary: </strong>An 82-year-old underwent successful non-surgical management of a large-neck pseudoaneurysm following TRA for a primary percutaneous coronary intervention of the left anterior descending artery. Clinical examination revealed a pulsatile mass at the puncture site, diagnosed via ultrasound as a pseudoaneurysm with a >1 mm neck. Through distal radial access, an initial 5 Fr sheath was upsized to 8 Fr based on ultrasound findings, achieving complete pseudoaneurysm exclusion. Follow-ups confirmed pseudoaneurysm sealing and radial artery patency.</p><p><strong>Discussion: </strong>This case illustrates an effective non-surgical approach to managing large-neck pseudoaneurysms post-TRA, utilizing an upsized sheath technique. It underscores the importance of innovative non-surgical strategies in complex cases, providing a safe and effective alternative to traditional management methods.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"8 11","pages":"ytae564"},"PeriodicalIF":0.8000,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549678/pdf/","citationCount":"0","resultStr":"{\"title\":\"Distal solution for an (un)conventional radial artery complication: a case report.\",\"authors\":\"Giuseppe Colletti, Gregory Angelo Sgueglia, Olivier Gach, Alexandre Natalis, Claudiu Ungureanu\",\"doi\":\"10.1093/ehjcr/ytae564\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The European Society of Cardiology guidelines recommend transradial access (TRA) for coronary angiography due to its advantages, including lower mortality and bleeding complications. Arterial pseudoaneurysms are rare but challenging complications of TRA, occurring in 0.009%-0.05% of procedures. Non-surgical management, especially in cases with large (>1 mm) necks or late discovery, can be difficult due to the limited effectiveness of echo-guided compression and risks of echo-guided thrombin injection, like thrombin embolization leading to necrosis.</p><p><strong>Case summary: </strong>An 82-year-old underwent successful non-surgical management of a large-neck pseudoaneurysm following TRA for a primary percutaneous coronary intervention of the left anterior descending artery. Clinical examination revealed a pulsatile mass at the puncture site, diagnosed via ultrasound as a pseudoaneurysm with a >1 mm neck. Through distal radial access, an initial 5 Fr sheath was upsized to 8 Fr based on ultrasound findings, achieving complete pseudoaneurysm exclusion. Follow-ups confirmed pseudoaneurysm sealing and radial artery patency.</p><p><strong>Discussion: </strong>This case illustrates an effective non-surgical approach to managing large-neck pseudoaneurysms post-TRA, utilizing an upsized sheath technique. It underscores the importance of innovative non-surgical strategies in complex cases, providing a safe and effective alternative to traditional management methods.</p>\",\"PeriodicalId\":11910,\"journal\":{\"name\":\"European Heart Journal: Case Reports\",\"volume\":\"8 11\",\"pages\":\"ytae564\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2024-10-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549678/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Heart Journal: Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/ehjcr/ytae564\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/11/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal: Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/ehjcr/ytae564","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

摘要

背景:欧洲心脏病学会指南推荐经桡动脉入路(TRA)进行冠状动脉造影术,因为它具有死亡率和出血并发症较低等优点。动脉假性动脉瘤是经桡动脉入路冠状动脉造影术罕见但具有挑战性的并发症,发生率为 0.009%-0.05%。由于回声引导压迫的效果有限,以及回声引导凝血酶注射的风险,如凝血酶栓塞导致坏死,因此非手术治疗,尤其是颈部较大(>1 毫米)或发现较晚的病例,可能会很困难。病例摘要:一位 82 岁的老人在接受左前降支动脉原发性经皮冠状动脉介入治疗 TRA 后,成功接受了非手术治疗大颈假性动脉瘤的手术。临床检查发现穿刺部位有搏动性肿块,经超声诊断为颈部大于 1 毫米的假性动脉瘤。根据超声检查结果,通过桡动脉远端入路,将最初的5 Fr鞘扩大到8 Fr,完全排除了假性动脉瘤。随访证实假性动脉瘤被封堵,桡动脉通畅:本病例展示了一种有效的非手术治疗方法,即利用加大鞘管技术治疗桡动脉后大颈假性动脉瘤。它强调了创新非手术策略在复杂病例中的重要性,为传统治疗方法提供了安全有效的替代方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Distal solution for an (un)conventional radial artery complication: a case report.

Background: The European Society of Cardiology guidelines recommend transradial access (TRA) for coronary angiography due to its advantages, including lower mortality and bleeding complications. Arterial pseudoaneurysms are rare but challenging complications of TRA, occurring in 0.009%-0.05% of procedures. Non-surgical management, especially in cases with large (>1 mm) necks or late discovery, can be difficult due to the limited effectiveness of echo-guided compression and risks of echo-guided thrombin injection, like thrombin embolization leading to necrosis.

Case summary: An 82-year-old underwent successful non-surgical management of a large-neck pseudoaneurysm following TRA for a primary percutaneous coronary intervention of the left anterior descending artery. Clinical examination revealed a pulsatile mass at the puncture site, diagnosed via ultrasound as a pseudoaneurysm with a >1 mm neck. Through distal radial access, an initial 5 Fr sheath was upsized to 8 Fr based on ultrasound findings, achieving complete pseudoaneurysm exclusion. Follow-ups confirmed pseudoaneurysm sealing and radial artery patency.

Discussion: This case illustrates an effective non-surgical approach to managing large-neck pseudoaneurysms post-TRA, utilizing an upsized sheath technique. It underscores the importance of innovative non-surgical strategies in complex cases, providing a safe and effective alternative to traditional management methods.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
European Heart Journal: Case Reports
European Heart Journal: Case Reports Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.30
自引率
10.00%
发文量
451
审稿时长
14 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信