Altıntaş Garip, Diken Adem İlkay, Ulaş Mahmut Mustafa, Çiçek Ömer Faruk, Özen Anıl, Ökten Sarper, Bardakçı Haşmet
Department of Cardiovascular Surgery, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey.
Ann Vasc Surg. 2012 Apr;26(3):421.e17-9. doi: 10.1016/j.avsg.2011.06.016. Epub 2012 Jan 27.
Many mechanical complications associated with insertion, maintenance, and removal of the hemodialysis catheters have been reported in the literature. A 47-year-old man was consulted to our hospital because of an entrapped hemodialysis catheter guidewire. Computed tomographic scan revealed that the right subclavian vein was perforated by the guidewire and the wire was knotted over itself, one loop inside the vein and two loops in the extravascular site. Guidewire is pulled out from a 3-cm incision over the wire loops lateral to the right sternocleidomastoid muscle. He was discharged home on postoperative day 2 without any complication. Our suggestion is that any abnormal resistance should be immediately evaluated for the presence of any potential knots using the most appropriate imaging technique.
文献中已报道了许多与血液透析导管插入、维护及拔除相关的机械并发症。一名47岁男性因血液透析导管导丝陷入而前来我院就诊。计算机断层扫描显示，导丝穿透了右锁骨下静脉，且导丝自身打结，一个线圈在静脉内，两个线圈在血管外部位。通过在右胸锁乳突肌外侧的导丝线圈上方做一个3厘米的切口将导丝取出。术后第2天他出院，无任何并发症。我们的建议是，一旦出现任何异常阻力，应立即使用最合适的成像技术评估是否存在任何潜在的打结情况。
