Maués José Júlio Bechir, Hauter Heather Lynn
Hospital Saúde da Mulher - HSM, Departamento de Cirurgia Vascular e Endovascular, Belém, PA, Brasil.
J Vasc Bras. 2018 Jul-Sep;17(3):248-251. doi: 10.1590/1677-5449.010317.
A 47-year-old male police officer presented at an outpatients consulting room complaining of exertional dyspnea and swelling and pain in the right arm. He had suffered a perforating gunshot wound of the right infraclavicular region 7 months previously. A chest tomography showed considerable dilatation of the subclavian and cervical veins and veins of the right upper limb, with no clear point of arteriovenous communication. His symptoms exacerbated and he was admitted to hospital before the date scheduled for treatment. He underwent endovascular treatment with an 8x100 mm Fluency covered stent that was placed in the right subclavian artery using the through-and-through technique. Control angiography showed that the fistulous defect had been completely sealed. There was significant relief of the symptoms on the first day after the operation. Traumatic lesions of the subclavian artery are rare, but can be associated with high morbidity and mortality rates. Penetrating trauma is the main cause and arteriovenous fistulas should be ruled out when evaluating penetrating injuries in vascular territories.
一名47岁的男性警官到门诊咨询室就诊，主诉劳力性呼吸困难以及右臂肿胀疼痛。7个月前他右锁骨下区域遭受了贯通性枪伤。胸部断层扫描显示锁骨下静脉、颈静脉及右上肢静脉明显扩张，未见明确的动静脉交通点。他的症状加重，在预定治疗日期前入院。采用贯穿技术，在右锁骨下动脉置入一枚8×100 mm的Fluency覆膜支架进行血管内治疗。对照血管造影显示瘘口缺损已完全封闭。术后第一天症状明显缓解。锁骨下动脉创伤性损伤罕见，但可伴有高发病率和死亡率。穿透性创伤是主要原因，在评估血管区域的穿透性损伤时应排除动静脉瘘。
