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老年人桡动脉假性动脉瘤:一种治疗方法不明确的罕见病例。病例报告及文献综述

Radial pseudoaneurysm in elderly: a rare event with undefinied therapeutical approach. A case report and literature review.

作者信息

Gallinoro Emanuele, Natale Francesco, D’Elia Saverio, Golino Paolo, Cimmino Giovanni

机构信息

University of Campania "Luigi Vanvitelli", Naples, Italy. Cardiology Unit "Vanvitelli", Monaldi Hospital.

出版信息

Monaldi Arch Chest Dis. 2019 Sep 10;89(3). doi: 10.4081/monaldi.2019.1109.

Abstract

Radial artery pseudoaneurysm (RAP) after cardiac catheterization in elderly patients is a rare complication. Clinical manifestations are pain, swelling and haematoma of the harm. The diagnosis is made through doppler ultrasonography, but the best therapeutical option is still matter of debate. Traditionally, surgical treatment has been considered the gold standard but new and less invasive strategies have been recently proposed: ultrasound-guided compression and local injection of thrombin. In this report we describe the unique case of an 84-year-old female patient who developed radial artery pseudoaneurysm after a failed radial artery access for cardiac catheterization. Finally, the pseudoaneurysm was successfully treated by surgical approach as several attempts of local compression failed. We aimed also at reviewing the treatment options of RAP in elderly patients (>75 years old) and the safety/effectiveness reported in literature.

摘要

老年患者心脏导管插入术后桡动脉假性动脉瘤(RAP)是一种罕见的并发症。临床表现为患处疼痛、肿胀和血肿。通过多普勒超声进行诊断,但最佳治疗方案仍存在争议。传统上,手术治疗被视为金标准,但最近有人提出了新的、侵入性较小的策略:超声引导下压迫和局部注射凝血酶。在本报告中,我们描述了一例独特的病例,一名84岁女性患者在心脏导管插入术桡动脉穿刺失败后发生了桡动脉假性动脉瘤。最后,由于多次局部压迫尝试失败,该假性动脉瘤通过手术方法成功治疗。我们还旨在回顾老年患者(>75岁)RAP的治疗选择以及文献中报道的安全性/有效性。

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