血管内栓塞后外周循环发现脑圈缺失:一种罕见的并发症及回顾

Shaikh Nissar, Nawaz Shoaib, A. Sumayya, Khan Adnan, Alkubaisi Aisha, Momin Umais Zaid, Thabet Abdulnasser
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引用次数: 1

摘要

脑动脉瘤腔内栓塞术在临床上是很常见的。血管内栓塞的罕见并发症是线圈错位。大多数报道的线圈错位是由于过早释放线圈进入脑循环造成的。我们报告一例线圈丢失进入外周循环由于未能脱离微导管在正确的位置。病例:一位无病史的年轻女士,因严重头痛就诊于急诊科。她的意识水平下降,GCS降至5,需要立即插管、镇静和通气。计算机断层扫描和血管造影显示左侧颈内动脉有一个巨大的颈内动脉瘤。她在全身麻醉下接受血管内盘绕,并成功地将一个线圈插入动脉瘤。在插入第二个线圈时,线圈无法与微导管分离,线圈卡在颈动脉分叉处,在多次尝试移除失败后,线圈被卷进了全身循环,在x线检查中未被发现。第二天,四肢x光片显示左腘动脉线圈。患者接受血管造影,成功去除错位的线圈,并将动脉瘤完全栓塞。在支持性护理下,她的病情得到改善,到第14天,她成功拔管,一周后出院回家。结论:栓塞时线圈不能脱离导管进入外周循环。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Missed Cerebral Coil Found in Peripheral Circulation after Endovascular Embolization: A Rare Complication and Review
Endovascular embolization of cerebral aneurysm is common in clinical practice. The rare complication of endovascular embolization is coil misplacement. Most of the reported coil misplacements occur due to premature release of a coil into the cerebral circulation. We report a case of a coil lost into the peripheral circulation due to failed detachment from the micro-catheter at the right place. Case: A young lady without medical history, presented at the emergency department with severe headache. Her consciousness level deteriorated, and her GCS dropped to 5, requiring immediate intubation, sedation and ventilation. Computer tomography and angiography showed a giant supraclinoid aneurysm of the left internal carotid artery. She was taken for endovascular coiling under general anesthesia and one coil was successfully inserted in the aneurysm. During the insertion of the second coil, it was not possible to detach the coil from the micro-catheter, the coil got stuck at the level of the carotid bifurcation and after several failed attempts to remove it, the coil was swept away into the general circulation and went undetected on fluoroscopy. Next day extremity X-ray showed the coil in the left popliteal artery. Patient was taken for angiography, the misplaced coil was successfully removed and the aneurysm was completely embolized. Her condition improved with supportive care and by day 14 she was successfully extubated and discharged home after another week. Conclusion: During embolization coil can fail to get detached from the catheter and can go into the peripheral circulation.
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