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覆膜血管内支架植入术急诊修复锁骨区大血管损伤的病例报告

Case report of emergency repair of injury to the great vessels of the clavicular region by coated endovascular stent implantation.

作者信息

Wang Jian, Lao Jie, Liu Yangbo, Zhuo Gaobao, Zhang Huaibao, Chen Lei

机构信息

First Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang 325000; ; Shanghai Huashan Hospital, Fudan University, Shanghai 200040, P.R. China.

出版信息

Exp Ther Med. 2013 Jul;6(1):61-64. doi: 10.3892/etm.2013.1097. Epub 2013 May 2.

Abstract

The subclavian artery leaves the thoracic cage at the outer margin of the first rib, where it becomes the axillary artery. Rupture and hemorrhage of the subclavian artery may result in ischemia and necrosis of the upper limb, brachial plexus injury, and even hemorrhagic shock or mortality. A patient with an injury to the proximal segment of the axillary artery underwent emergency repair using a coated endovascular stent graft. The patient was followed up for 13 months and examined using CT imaging, B-mode ultrasonography and electromyography to evaluate stent function and brachial plexus recovery. The endovascular stent graft remained correctly positioned and patent, extending across the injured part of the vessel. Neurolysis at 3 months after injury was effective in restoring the majority of the brachial plexus function. The coated endovascular stent graft was effective in treating the acute injury to the great vessels in the clavicular region. Follow-up of brachial plexus function is important and secondary neurolysis should be performed if necessary.

摘要

锁骨下动脉在第一肋的外缘离开胸廓,在此处它成为腋动脉。锁骨下动脉破裂和出血可能导致上肢缺血和坏死、臂丛神经损伤,甚至失血性休克或死亡。一名腋动脉近端损伤的患者接受了带涂层血管内支架移植物的紧急修复。对该患者进行了13个月的随访,并使用CT成像、B型超声和肌电图进行检查,以评估支架功能和臂丛神经恢复情况。血管内支架移植物位置正确且通畅,跨越了血管的损伤部位。损伤后3个月进行的神经松解术有效地恢复了大部分臂丛神经功能。带涂层血管内支架移植物对治疗锁骨区域大血管的急性损伤有效。臂丛神经功能的随访很重要,必要时应进行二次神经松解术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8af9/3735842/809af7314927/ETM-06-01-0061-g00.jpg

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