Martin Matthias, Baumgartner Iris, Kolb Martin, Triller Jürgen, Dinkel Hans-Peter
Department of Diagnostic Radiology, Swiss Cardiovascular Center, University Hospital, Bern, Switzerland.
J Endovasc Ther. 2002 Oct;9(5):680-4. doi: 10.1177/152660280200900520.
To report a rare, fatal complication of superior vena cava Wallstent implantation.
A 59-year-old man presenting with superior vena cava syndrome caused by small-cell lung cancer underwent stent implantation of 2 kissing Wallstents >1.5 cm above the right atrium. Despite correct stent deployment, vessel perforation occurred in a section not encased by tumor, which led to fatal pericardial tamponade shortly after the procedure. Autopsy revealed perforation of a stent strut through the caval wall into the pericardial space. Anatomical and methodological reasons are discussed.
The interventionist should be aware of this rare complication. Alternative stent designs avoiding the sharp ends of Wallstents and Palmaz stents should be considered.
报告一例上腔静脉Wallstent支架植入术罕见的致命并发症。
一名59岁男性因小细胞肺癌导致上腔静脉综合征，在右心房上方>1.5 cm处植入了2个相互吻接的Wallstent支架。尽管支架放置正确，但在未被肿瘤包绕的部位发生了血管穿孔，导致术后不久出现致命性心包填塞。尸检显示支架支柱穿过腔静脉壁进入心包腔。文中讨论了解剖学和方法学原因。
介入医生应意识到这种罕见的并发症。应考虑采用替代的支架设计，避免使用Wallstent支架和Palmaz支架的尖锐末端。
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