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甲状腺颈干穿孔:经右桡动脉途径进行心脏介入治疗期间罕见的血管并发症:一例报告及文献复习

Thyrocervical trunk perforation: A rare vascular complication during cardiac intervention through right radial approach: A case report and literature review.

作者信息

Ghori Masood Ayyub, Al Zubaidi Abdulmajeed, Khwaja Asim

机构信息

Cardiac Science Department, Sheikh Khalifa Medical City, Abu Dhabi, United Arab EmiratesUnited Arab Emirates.

Radiology Department, Sheikh Khalifa Medical City, Abu Dhabi, United Arab EmiratesUnited Arab Emirates.

出版信息

J Saudi Heart Assoc. 2019 Jul;31(3):121-124. doi: 10.1016/j.jsha.2019.03.002. Epub 2019 Mar 28.

Abstract

Trans radial artery access (TRA) is considered a relatively safe approach for percutaneous coronary intervention (PCI), by virtue of its fewer access related peripheral vascular complications. Central arterial complications are rare. We are presenting a case report wherein thyrocervical trunk (TT), a branch of first part of right subclavian artery (RSA) was perforated during intervention through right radial approach, resulting in deep neck hematoma, compressing the trachea and surrounding structure. To our knowledge, this is the first reported case of TT perforation by a hydrophilic wire during a staged cardiac catheterization after primary PCI through right radial approach. Knowledge of such a rare complication, its early recognition, and endovascular treatment might spare a patient with recent acute coronary syndrome on double antiplatelet medications, from surgical intervention and fatal outcome.

摘要

经桡动脉途径(TRA)因与穿刺相关的外周血管并发症较少,被认为是经皮冠状动脉介入治疗(PCI)相对安全的方法。中枢动脉并发症罕见。我们现报告一例病例,在经右桡动脉途径进行介入操作时,右锁骨下动脉(RSA)第一部分的分支甲状颈干(TT)被穿刺,导致颈部深部血肿,压迫气管及周围结构。据我们所知,这是首例在经右桡动脉途径进行初次PCI后的分期心脏导管插入术中亲水性导丝导致TT穿孔的报道病例。了解这种罕见并发症、其早期识别及血管内治疗,可能使正在接受双联抗血小板药物治疗的近期急性冠脉综合征患者避免手术干预及致命后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b250/6479075/a698a4b81dc8/gr1.jpg

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