Bani-Hani Samer, Showkat Arif, Wall Barry M, Das Prnab, Huang Liwei, Al-Absi Ahmed I
Nephrology Division, University of Tennessee Health Sciences Center (UTHSC), Memphis, TN 38016, USA.
Semin Dial. 2012 Sep-Oct;25(5):562-4. doi: 10.1111/j.1525-139X.2011.01039.x. Epub 2012 Feb 20.
Central stenosis of the subclavian and internal jugular veins is common in end stage renal disease. Treatment of these stenoses is difficult as these veins respond poorly to angioplasty alone and often require metallic stents to ensure patency. These stents are not without complications. Reports of stent fracture, thrombosis and vessel rupture abound in the literature. Stent migration can occur when used in large central veins leading to severe consequences such as pulmonary infarction, tricuspid regurgitation and right sided heart failure. In this report, we report a case of a subclavian vein stent which migrated into the right heart and caused subendocardial injury. As the use of vascular stents is becoming a common treatment option for central venous stenosis, the occurrences of serious complications associated with the stents are likely to rise.
锁骨下静脉和颈内静脉的中央狭窄在终末期肾病中很常见。这些狭窄的治疗很困难,因为这些静脉对单纯血管成形术反应不佳,通常需要金属支架来确保通畅。这些支架并非没有并发症。文献中充斥着支架断裂、血栓形成和血管破裂的报道。当用于大的中央静脉时,支架可能会迁移,导致严重后果,如肺梗死、三尖瓣反流和右侧心力衰竭。在本报告中,我们报告了一例锁骨下静脉支架迁移至右心并导致心内膜下损伤的病例。随着血管支架的使用成为中央静脉狭窄的常见治疗选择,与支架相关的严重并发症的发生率可能会上升。