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Endovascular treatment of symptomatic high-flow vertebral arteriovenous fistula as a complication after c1 screw insertion.经血管内治疗症状性高流量椎动脉动静脉瘘作为C1螺钉置入术后的并发症
J Korean Neurosurg Soc. 2014 Oct;56(4):348-52. doi: 10.3340/jkns.2014.56.4.348. Epub 2014 Oct 31.
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Future directions for ultrasound-guided central venous access.超声引导下中心静脉置管的未来发展方向。
Eur J Anaesthesiol. 2011 May;28(5):327-8. doi: 10.1097/EJA.0b013e328343b148.
3
Evaluation of transcatheter arterial embolization with gelatin sponge particles, microcoils, and n-butyl cyanoacrylate for acute arterial bleeding in a coagulopathic condition.评估使用明胶海绵颗粒、微线圈和氰基丙烯酸正丁酯进行经导管动脉栓塞术治疗凝血功能障碍状态下的急性动脉出血。
J Vasc Interv Radiol. 2009 Sep;20(9):1176-87. doi: 10.1016/j.jvir.2009.06.005. Epub 2009 Jul 30.
4
Arterial trauma during central venous catheter insertion: Case series, review and proposed algorithm.中心静脉导管插入过程中的动脉损伤：病例系列、综述及拟议算法
J Vasc Surg. 2008 Oct;48(4):918-25; discussion 925. doi: 10.1016/j.jvs.2008.04.046. Epub 2008 Aug 13.
5
Iatrogenic vertebral artery injury.医源性椎动脉损伤
Acta Neurol Scand. 2005 Dec;112(6):349-57. doi: 10.1111/j.1600-0404.2005.00497.x.
6
[Subclavian intravenous injection; advantages and technic].[锁骨下静脉注射；优点与技术]
Presse Med (1893). 1952 Oct 25;60(68):1456.
7
Does ultrasound imaging before puncture facilitate internal jugular vein cannulation? Prospective randomized comparison with landmark-guided puncture in ventilated patients.穿刺前超声成像是否有助于颈内静脉置管？与通气患者中基于体表标志引导穿刺的前瞻性随机对照研究。
J Cardiothorac Vasc Anesth. 2002 Oct;16(5):572-5. doi: 10.1053/jcan.2002.126950.
8
Fatal brainstem stroke following internal jugular vein catheterization.颈内静脉置管后发生致命性脑干卒中。
Neurology. 1991 Jul;41(7):1092-5. doi: 10.1212/wnl.41.7.1092.

凝血功能障碍患者中心静脉置管所致意外椎动脉损伤的处理

Management of inadvertent vertebral artery injury due to central venous catheterization in a coagulopathic patient.

作者信息

Yamamoto Akitaka, Suzuki Kei, Sakaida Hiroshi, Suzuki Hidenori, Imai Hiroshi

机构信息

Emergency and Critical Care Center Mie University Hospital Tsu Mie Japan.

Department of Neurosurgery Mie University Graduate School of Medicine Tsu Mie Japan.

出版信息

Acute Med Surg. 2015 Nov 29;3(3):265-267. doi: 10.1002/ams2.177. eCollection 2016 Jul.

DOI:10.1002/ams2.177
PMID:29123795
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5667242/
Abstract

CASE

A 72-year-old man was admitted to the intensive care unit for severe pancreatitis with coagulopathy. He underwent hemodialysis catheter insertion into the internal jugular vein that subsequently leaked arterial blood; vertebral artery cannulation was suspected following a computed tomography scan.

OUTCOME

Under angiographic guidance, the catheter was removed, and an arteriovenous fistula was identified. The patient was successfully treated with endovascular embolization of the affected vertebral artery with detachable coils and N-butyl-2-cyanoacrylate.

CONCLUSION

Despite ultrasound guidance, vertebral cannulation can occur, which can result in serious complications. Prompt management is needed to prevent further sequelae. Endovascular embolization with detachable coils and N-butyl-2-cyanoacrylate appears to be an effective option for vertebral artery injury in patients with coagulopathy.

摘要

病例

一名72岁男性因重症胰腺炎合并凝血功能障碍入住重症监护病房。他接受了颈内静脉血液透析导管插入术，随后导管出现动脉血渗漏；计算机断层扫描后怀疑发生了椎动脉插管。

结果

在血管造影引导下，移除了导管，并发现了动静脉瘘。患者通过使用可脱卸弹簧圈和N-丁基-2-氰基丙烯酸酯对受影响的椎动脉进行血管内栓塞治疗而成功治愈。

结论

尽管有超声引导，仍可能发生椎动脉插管，这可能导致严重并发症。需要及时处理以防止进一步的后遗症。对于合并凝血功能障碍的患者，使用可脱卸弹簧圈和N-丁基-2-氰基丙烯酸酯进行血管内栓塞似乎是治疗椎动脉损伤的有效选择。