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[颈内静脉置管继发锁骨下动脉损伤的血管腔内修复:病例报告]

[Endovascular repair of subclavian artery injury secondary to internal jugular vein catheterization: case report].

作者信息

Kim Jong Ho, Kim Young Joon, Jang Ji Su, Hwang Sung Mi

机构信息

Hallym University, Chuncheon Sacred Heart Hospital, Department of Anesthesiology and Pain Medicine, Chuncheon, Coreia do Sul.

Kangwon National University, College of Medicine, Department of Anesthesiology and Pain Medicine, Chuncheon, Coreia do Sul.

出版信息

Braz J Anesthesiol. 2019 Jul-Aug;69(4):413-416. doi: 10.1016/j.bjan.2018.12.006. Epub 2019 Jul 26.

Abstract

BACKGROUND AND OBJECTIVES

Ultrasound-guided internal jugular vein catheterization is a common and generally safe procedure in the operating room. However, inadvertent puncture of a noncompressible artery such as the subclavian artery, though rare, may be associated with life-threatening sequelae, including hemomediastinum, hemothorax, and pseudoaneurysm.

CASE REPORT

We describe a case of the successful endovascular repair of right subclavian artery injury in a 75-year-old woman. Subclavian artery was injured secondary to ultrasound-guided right internal jugular vein catheterization under general anesthesia for orthopedic surgery.

CONCLUSION

Under general anesthesia several factors such as hypotension can mask the signs of subclavian artery injury. This case report indicates that clinicians should be aware of the complications of central venous catheterization and take prompt action.

摘要

背景与目的

超声引导下颈内静脉置管术在手术室是一种常见且总体安全的操作。然而,意外穿刺不可压缩动脉(如锁骨下动脉)虽罕见,但可能会引发危及生命的后遗症,包括纵隔积血、血胸和假性动脉瘤。

病例报告

我们描述了一例75岁女性右锁骨下动脉损伤成功进行血管内修复的病例。锁骨下动脉损伤继发于骨科手术全身麻醉下超声引导的右颈内静脉置管术。

结论

在全身麻醉下,低血压等多种因素可能掩盖锁骨下动脉损伤的体征。本病例报告表明临床医生应意识到中心静脉置管的并发症并迅速采取行动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9654/9391839/f45fd4b49369/gr1.jpg

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