血液透析中心静脉置管期间锁骨下动脉损伤的血管内处理。

Open Access Emergency Medicine : OAEM Pub Date : 2021-06-24 eCollection Date: 2021-01-01 DOI:10.2147/OAEM.S308233
Imtinene Ben Mrad, Lilia Ben Fatma, Melek Ben Mrad, Rim Miri, Sobhy Mleyhi, Ikram Mami, Ihsen Zairi, Raouf Denguir
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引用次数: 2

摘要

中心静脉置管后锁骨下动脉损伤是一种罕见但可能致命的并发症。锁骨下动脉创伤的外科修复是一个真正的挑战,与高发病率和死亡率有关。血管内治疗对包括锁骨下动脉损伤在内的血管创伤的作用在不断发展。在这篇文章中,我们报告了一例52岁的慢性肾衰竭5期患者,在放置中心静脉导管进行透析后,通过覆盖支架对锁骨下动脉穿孔进行紧急血管内修复。本病例提示在中心静脉置管过程中应注意防止医源性动脉插管,以避免潜在的破坏性并发症。使用覆膜支架的血管内治疗应作为一线治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Endovascular Management of a Subclavian Arterial Injury During Central Venous Catheter Placement for Hemodialysis.

Endovascular Management of a Subclavian Arterial Injury During Central Venous Catheter Placement for Hemodialysis.

Endovascular Management of a Subclavian Arterial Injury During Central Venous Catheter Placement for Hemodialysis.

Endovascular Management of a Subclavian Arterial Injury During Central Venous Catheter Placement for Hemodialysis.

Subclavian artery injuries after central venous catheter placement constitute a rare but potentially fatal complication. The surgical repair of a subclavian artery trauma is a real challenge, associated with a high rate of morbidity and mortality. The role of endovascular treatment for vascular trauma, including injury to the subclavian artery, continues to evolve. In this manuscript, we report the case of an urgent endovascular repair by a covered stent graft of a subclavian artery perforation following the placement of a central venous catheter for dialysis in a 52-year-old patient, having a chronic kidney failure stage 5, with multiple comorbidities. The present case suggests that attention needs to be paid to preventing iatrogenic arterial cannulation during central vein catheterization to avoid potentially devastating complications. Endovascular treatment using a covered stent should be attempted as a first-line therapeutic option.

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