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肺循环内游走性支架。

Wandering stent within the pulmonary circulation.

作者信息

Kakisis John D, Vassilas Konstantinos, Antonopoulos Constantine, Sfyroeras George, Moulakakis Konstantinos, Liapis Christos D

机构信息

Department of Vascular Surgery, Athens University Medical School, "Attikon" Hospital, Athens, Greece.

Department of Vascular Surgery, Athens University Medical School, "Attikon" Hospital, Athens, Greece.

出版信息

Ann Vasc Surg. 2014 Nov;28(8):1932.e9-1932.e12. doi: 10.1016/j.avsg.2014.06.074. Epub 2014 Jul 11.

Abstract

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.

摘要

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。

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