Gillon Stuart, Ammar Thoraya, Adlam Michael, Pahl Clemens
Department of Critical Care, King's College Hospital, Denmark Hill, London, UK.
Department of Radiology, King's College Hospital, Denmark Hill, London, UK.
J Intensive Care Soc. 2015 Feb;16(1):71-74. doi: 10.1177/1751143714551251. Epub 2014 Dec 9.
An extensive caval thrombus was incidentally detected in a neurosurgical patient by clinician-delivered critical care echocardiography. Recent intracranial haemorrhage prevented therapeutic anticoagulation; the very proximal nature of the thrombus precluded standard deployment of an inferior vena cava filter. We describe the novel radiological technique employed to manage the thrombus, and examine whether a thermoregulatory central venous catheter inserted as part of standard neuro-critical care may have contributed to the risk and extent of the caval thrombus.
一名神经外科患者在接受临床医生进行的重症监护超声心动图检查时,意外发现广泛的腔静脉血栓形成。近期的颅内出血使治疗性抗凝无法进行;血栓位置非常靠近心脏,导致无法标准放置下腔静脉滤器。我们描述了用于处理该血栓的新型放射学技术,并探讨作为标准神经重症监护一部分插入的温度调节中心静脉导管是否可能增加了腔静脉血栓形成的风险及严重程度。