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动静脉瘘作为经桡动脉冠状动脉造影的并发症:一例病例报告。

Arteriovenous fistula as a complication of transradial coronary angiography: a case report.

作者信息

Dehghani Payam, Culig Jennifer, Patel Darshan, Kraushaar Greg, Schulte Paul

机构信息

Prairie Vascular Research Network; Department of Cardiology, University of Saskatchewan, 2574 Linner Way, Regina, SK S4V 1K3, Canada.

出版信息

J Med Case Rep. 2013 Jan 14;7:21. doi: 10.1186/1752-1947-7-21.

Abstract

INTRODUCTION

Iatrogenic arteriovenous fistula is a vascular condition that may result from coronary angiography. Many case reports have described arteriovenous fistula occurrence after coronary angiography using the transfemoral access route, but rarely as a complication of using the transradial approach. We report a rare case of a patient with arteriovenous fistula following transradial artery coronary angiography.

CASE PRESENTATION

A 62-year-old Caucasian man underwent emergent coronary angiography using the right radial artery approach. One month after angiography, he discovered a turbulent sound near the access site. A right radial arteriovenous fistula was found upon duplex ultrasound investigation. The patient was treated conservatively. At 1-year follow-up, the arteriovenous fistula was unchanged and the patient remained hemodynamically stable and asymptomatic.

CONCLUSION

Iatrogenic arteriovenous fistula is a rare vascular complication of transradial artery coronary angiography. The natural history of arteriovenous fistula is benign and is thought to resolve spontaneously; therefore, a conservative approach, as opposed to surgical ligation, is recommended as the first-line treatment.

摘要

引言

医源性动静脉瘘是一种可能由冠状动脉造影引起的血管疾病。许多病例报告描述了经股动脉途径进行冠状动脉造影后发生动静脉瘘的情况,但很少作为经桡动脉途径的并发症出现。我们报告一例经桡动脉冠状动脉造影后发生动静脉瘘的罕见病例。

病例介绍

一名62岁的白种男性采用右桡动脉途径进行了急诊冠状动脉造影。造影后一个月,他在穿刺部位附近发现有杂音。经双功超声检查发现右桡动脉动静脉瘘。该患者接受了保守治疗。在1年的随访中,动静脉瘘情况未变,患者血流动力学保持稳定且无症状。

结论

医源性动静脉瘘是经桡动脉冠状动脉造影罕见的血管并发症。动静脉瘘的自然病程是良性的,被认为可自发消退;因此,与手术结扎相反,推荐采用保守治疗作为一线治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac27/3562163/696d4b189616/1752-1947-7-21-1.jpg

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