Kakisis John D, Vassilas Konstantinos, Antonopoulos Constantine, Sfyroeras George, Moulakakis Konstantinos, Liapis Christos D
Department of Vascular Surgery, Athens University Medical School, "Attikon" Hospital, Athens, Greece.
Department of Vascular Surgery, Athens University Medical School, "Attikon" Hospital, Athens, Greece.
Ann Vasc Surg. 2014 Nov;28(8):1932.e9-1932.e12. doi: 10.1016/j.avsg.2014.06.074. Epub 2014 Jul 11.
To present a case of a wandering stent within the pulmonary circulation that was managed conservatively with the "wait-and-see" strategy. Accidental dislodgement of a left brachiocephalic vein stent into the left lower lobe pulmonary artery occurred in an 83-year-old patient suffering from end-stage renal disease during placement of a left jugular vein catheter. The following day, a second X-ray revealed migration of the stent from the left to the right lower lobe pulmonary artery. Our patient was managed conservatively with low-molecular-weight heparin and was discharged on clopidogrel. The patient remained asymptomatic with regard to the migrated stent for four and a half years and died of old age. This is the first case of a wandering stent within the pulmonary circulation reported in the literature, supporting the "wait-and-see" policy in the management of such patients.
报告一例在肺循环中游走的支架,采用“观察等待”策略进行保守治疗。一名83岁终末期肾病患者在放置左颈静脉导管时,左头臂静脉支架意外脱落至左下叶肺动脉。次日,第二次X线检查显示支架从左肺下叶肺动脉迁移至右肺下叶肺动脉。我们的患者采用低分子量肝素进行保守治疗,并在氯吡格雷治疗下出院。该患者在四年半的时间里,对于迁移的支架一直无症状,最终死于高龄。这是文献中报道的首例肺循环中游走支架的病例,支持对此类患者采用“观察等待”策略。