Serednicki Wojciech, Dobrowolska Elżbieta, Kałuża Katarzyna, Kopacz Michał, Wordliczek Jerzy
The Department of Anesthesiology and Intensive Care No 1, University Hospital, Krakow, Poland; Department of Anesthesiology and Intensive Care, Jagiellonian University, Medical College, Krakow, Poland.
The Department of Anesthesiology and Intensive Care No 1, University Hospital, Krakow, Poland.
Injury. 2015;46(6):1167-70. doi: 10.1016/j.injury.2015.03.013. Epub 2015 Mar 16.
To describe the successful, clinical use of the Angel(®) Catheter, a device used for the prevention of pulmonary embolism (PE) and central venous access in a critically ill, multi-trauma patient.
Authors report the case of a 35-year-old man, in critical condition with multiple trauma injuries sustained from a fall, who was admitted to the Department of Rescue Medicine and Multiorgan Trauma in Krakow, Poland.
Anticoagulation was interrupted due to the risk of intraoperative bleeding. Due to the continued presence of multiple VTE risk factors, the Angel(®) Catheter was placed at the bedside for the prevention of PE. At the time of removal, a CT scan demonstrated a filling defect, consistent with a fine emboli caught inside the filter. After removal, thrombus was found lodged in the tip of the catheter filter.
The Angel(®) Catheter protected this critically ill, multi-trauma patient from PE at a time when current methods otherwise used for the prevention of venous thromboembolism (VTE), specifically antithrombotic pharmacologic agents and mechanical compression, were contraindicated due to the patient's complex clinical condition. Unlike other invasive techniques used for the prevention of PE, the Angel(®) Catheter also provided the convenience and expedience of bedside placement, eliminating the mandatory involvement of interventional radiologists or vascular surgeons, the need for specialised equipment, and movement of the patient which delay the procedure, increasing the risk of thromboembolic events.
描述Angel（®）导管在一名重症多创伤患者中成功用于预防肺栓塞（PE）和中心静脉通路的临床应用情况。
作者报告了一名35岁男性的病例，该患者因跌倒导致多处创伤，病情危急，被收治于波兰克拉科夫的急救医学与多器官创伤科。
由于术中出血风险，抗凝治疗中断。鉴于多种静脉血栓栓塞（VTE）风险因素持续存在，在床边放置了Angel（®）导管以预防PE。拔除导管时，CT扫描显示有充盈缺损，与过滤器内捕获的微小栓子相符。拔除后，发现血栓嵌顿在导管过滤器尖端。
在因患者复杂临床状况而禁忌使用目前用于预防静脉血栓栓塞（VTE）的方法（特别是抗血栓药物和机械压迫）时，Angel（®）导管保护了这名重症多创伤患者免受PE的影响。与其他用于预防PE的侵入性技术不同，Angel（®）导管还提供了床边放置的便利性和快捷性，无需介入放射科医生或血管外科医生的强制参与，无需专门设备，也无需移动患者，从而避免了因延误操作而增加血栓栓塞事件的风险。
