Grayburn P A, Willard J E, Brickner M E, Eichhorn E J
Department of Internal Medicine, (Cardiology Division), Veteran's Affairs Medical Center, Dallas, Texas 75216.
Cathet Cardiovasc Diagn. 1991 Jun;23(2):141-3. doi: 10.1002/ccd.1810230219.
We present a case in which thrombus formation on a guidewire was visualized during intravascular ultrasound imaging despite the administration of 10,000 units of heparin sulfate prior to the procedure. Gross thrombus formation was confirmed upon removal of the guidewire. The activated clotting time was found to be 191 s, suggesting heparin resistance. This report graphically illustrates the potential thrombogenicity associated with intravascular guidewire manipulation during procedures such as intravascular ultrasound imaging and percutaneous transluminal coronary angioplasty. Moreover, this case suggests that adequate heparinization should be routinely verified by measuring the activated clotting time prior to introducing a guidewire into the arterial system.
我们报告了一例在血管内超声成像过程中，尽管在操作前给予了10000单位硫酸肝素，但仍在导丝上观察到血栓形成的病例。取出导丝后证实有明显的血栓形成。活化凝血时间为191秒，提示肝素抵抗。本报告以图示说明了在血管内超声成像和经皮腔内冠状动脉成形术等操作过程中，与血管内导丝操作相关的潜在血栓形成风险。此外，该病例表明，在将导丝引入动脉系统之前，应常规通过测量活化凝血时间来验证是否有足够的肝素化。
