下肢硬化治疗后并发脑空气栓塞的动脉内空气血栓形成。
Intra-arterial air thrombogenesis after cerebral air embolism complicating lower extremity sclerotherapy.
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(2):247-50. doi: 10.1007/s12028-009-9211-2. Epub 2009 Mar 17.
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 10 min 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。动脉内的空气可以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的一个极其罕见的原因。
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，突发左侧大脑中动脉（LMCA）综合征，美国国立卫生研究院卒中量表评分为 11。CT 血管造影显示 LMCA 内动脉空气。患者接受高压氧治疗后完全恢复，动脉内空气完全消退。然而，尽管用肝素进行抗凝治疗，血栓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，但也证明了这种程序并发症的血栓形成潜力。
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