Institut für Diagnostische und Interventionelle Radiologie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Cardiovasc Intervent Radiol. 2010 Apr;33(2):417-20. doi: 10.1007/s00270-009-9613-8. Epub 2009 Jun 6.
Long-term utilization of central venous catheters (CVCs) for parenteral nutrition has a high incidence of central venous complications including infections, occlusions, and stenosis. We report the case of a 31-year-old woman presenting with a malabsorption caused by short gut syndrome due to congenital aganglionic megacolon. The patient developed a chronic occlusion of all central neck and femoral veins due to long-term use of multiple CVCs over more than 20 years. In patients with central venous occlusion and venous transformation, the implantation of a totally implanted port system by accessing collateral veins is an option to continue long-term parenteral nutrition when required. A 0.014-in. Whisper guidewire (Terumo, Tokyo) with high flexibility and steerability was chosen to maneuver and pass through the collateral veins. We suggest this approach to avoid unfavorable translumbar or transhepatic central venous access and to conserve the anatomically limited number of percutaneous access sites.
长期使用中心静脉导管（CVC）进行肠外营养会导致较高的中心静脉并发症发生率，包括感染、阻塞和狭窄。我们报告了一例 31 岁女性病例，因先天性无神经节性巨结肠导致短肠综合征而出现吸收不良。该患者由于长期使用多个 CVC 超过 20 年，导致所有中心颈部和股静脉出现慢性阻塞。对于中心静脉阻塞和静脉转化的患者，当需要长期肠外营养时，通过侧支静脉植入完全植入式端口系统是一种选择。选择 0.014 英寸的 Whisper 导丝（Terumo，东京），因其具有高柔韧性和可操控性，用于在侧支静脉中进行操作和通过。我们建议采用这种方法，以避免不利的经皮肝穿刺或经皮肝穿刺中心静脉通路，并保留经皮穿刺通路的解剖数量有限。
