Ghazala Christopher George, Marrow Benjamin Alexander, Kearney Dermot, Harrison John William Kenneth
Department of Trauma and Orthopaedic Surgery, Gateshead Health NHS Foundation Trust, Gateshead, UK.
Department of Cardiology, Gateshead Health NHS Foundation Trust, Gateshead, UK.
BMJ Case Rep. 2019 Mar 12;12(3):e227136. doi: 10.1136/bcr-2018-227136.
Coronary angiography and percutaneous coronary intervention (PCI) are frequently performed procedures in the UK and the developed world, with the radial artery becoming the preferred route of access. A chronically retained macroscopic fragment of radial artery introducer sheath is a very rare complication that has not, to our knowledge, been reported. We report the case of a 62-year-old woman who underwent PCI and developed a persisting infected sinus and abscess at the cannulation site despite multiple courses of antibiotics. Surgical exploration of the forearm recovered a foreign body that was found in the brachioradialis muscle and resembled a fragment of hydrophilic sheath. In conclusion, this case highlights that it is possible to leave macroscopic fragments of hydrophilic sheaths in situ. This is likely to be encountered during difficult access, especially during arterial spasm, and it is advised that the sheath and any other vascular access device is thoroughly inspected following removal.
冠状动脉造影和经皮冠状动脉介入治疗（PCI）在英国及发达国家是常见的诊疗操作，桡动脉已成为首选的入路途径。桡动脉穿刺鞘的宏观碎片长期留存是一种极为罕见的并发症，据我们所知，此前尚无相关报道。我们报告了一例62岁女性患者，她接受了PCI治疗，尽管接受了多疗程抗生素治疗，但插管部位仍出现持续感染的窦道和脓肿。对前臂进行手术探查时，在肱桡肌中发现了一个异物，其类似亲水鞘的碎片。总之，该病例表明亲水鞘的宏观碎片有可能残留原位。这种情况可能在穿刺困难时出现，尤其是在动脉痉挛期间，建议在移除鞘管及任何其他血管入路装置后进行彻底检查。
