下肢硬化治疗并发脑空气栓塞后动脉内空气血栓形成。
Intra-arterial air thrombogenesis after cerebral air embolism complicating lower extremity sclerotherapy.
作者信息
Leslie-Mazwi T M, Avery Laura L, Sims John R
机构信息
Department of Neurology, Massachusetts General Hospital, WAC 7., 55 Fruit Street, Boston, MA 02114, USA.
出版信息
Neurocrit Care. 2009;11(1):97-100. doi: 10.1007/s12028-009-9202-3. Epub 2009 Mar 11.
BACKGROUND
Cerebral arterial gas embolism is a potentially life-threatening event. Intraarterial air can occlude blood flow directly or cause thrombosis. Sclerotherapy is an extremely rare cause of cerebral arterial gas embolism.
METHOD
Case-report.
RESULTS
A 38-year-old female suffered acute onset of a left middle cerebral artery (LMCA) syndrome with an NIH stroke score of 11 approximately ten minutes after lower extremity sclerotherapy. CT angiogram demonstrated LMCA intraarterial air. Patient fully recovered after hyperbaric oxygen treatment with complete resolution of intraarterial air. However, thrombus replaced intraarterial air despite anticoagulation with heparin.
CONCLUSION
We provide radiological evidence of hyperbaric oxygen therapy resolving intraarterial air but also demonstrate the thrombogenic potential of this procedural complication.
背景
脑动脉气体栓塞是一种潜在的危及生命的事件。动脉内空气可直接阻塞血流或导致血栓形成。硬化疗法是脑动脉气体栓塞极其罕见的病因。
方法
病例报告。
结果
一名38岁女性在下肢硬化疗法后约10分钟急性发作左大脑中动脉（LMCA）综合征，美国国立卫生研究院卒中量表（NIHSS）评分11分。CT血管造影显示LMCA动脉内有空气。患者接受高压氧治疗后完全康复，动脉内空气完全消散。然而，尽管使用肝素抗凝，血栓还是取代了动脉内的空气。
结论
我们提供了高压氧治疗消除动脉内空气的影像学证据，但也证明了这种手术并发症的血栓形成潜力。
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