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体外膜肺氧合插管期间股总动脉穿孔的成功血管内治疗

Successful Endovascular Management of Common Femoral Artery Perforation During Cannulation for Extracorporeal Membrane Oxygenation.

作者信息

Lee Su Nam, Yoo Ki-Dong, Jo Min Seop

机构信息

Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea.

Department of Thoracic and Cardiovascular Surgery, St. Vincent's Hospital, The Catholic University of Korea.

出版信息

Int Heart J. 2019 Jan 25;60(1):231-234. doi: 10.1536/ihj.18-266. Epub 2018 Nov 5.

Abstract

In massive pulmonary thromboembolism, requiring cardiopulmonary resuscitation, venous-arterial extracorporeal membrane oxygenation can decompress the overloaded right atrium and ventricle while stabilizing hemodynamic status. However, vascular injuries occur in slightly less than 20% of cases during cannulation. In a 44-year-old woman with suspected pulmonary thromboembolism, a common femoral artery perforation occurred unexpectedly during cannulation for extracorporeal membrane oxygenation. The patient was unstable due to active bleeding. Fortunately, we occluded the bleeding site using a stent. Interventional cardiologists are frequently challenged by vascular injury during cannulation for extracorporeal membrane oxygenation. We recommend imaging modalities to prevent vascular complications. However, if vascular injuries occur, stent placement should be considered for patients with arterial perforation during cannulation for extracorporeal membrane oxygenation.

摘要

在需要进行心肺复苏的大面积肺血栓栓塞症中,静脉 - 动脉体外膜肺氧合可在稳定血流动力学状态的同时,减轻超负荷的右心房和右心室的压力。然而,在插管过程中,血管损伤在不到20%的病例中发生。在一名疑似肺血栓栓塞症的44岁女性患者中,体外膜肺氧合插管期间意外发生了股总动脉穿孔。由于活动性出血,患者病情不稳定。幸运的是,我们使用支架封堵了出血部位。介入心脏病学家在体外膜肺氧合插管过程中经常面临血管损伤的挑战。我们推荐使用成像方式来预防血管并发症。然而,如果发生血管损伤,对于体外膜肺氧合插管期间动脉穿孔的患者,应考虑放置支架。

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