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反复颈静脉置管后发生医源性双侧颈静脉、锁骨下静脉和上腔静脉闭塞,伴阿诺德-奇亚里畸形:血管内治疗成功。

Iatrogenic occlusion of bilateral jugular veins, subclavian vein, and superior vena cava after repeated jugular cannulation associated with Arnold-Chiari malformation: Successful endovascular treatment.

作者信息

Nowakowski Przemyslaw, Buszman Piotr, Kiesz Stefan, Buszman Pawel

机构信息

Department of Vascular Surgery, American Heart of Poland, Chrzanow, Poland.

Andrzej Frycz-Modrzewski Krakow University, Krakow, Poland.

出版信息

J Vasc Surg Cases Innov Tech. 2020 Feb 4;6(1):18-20. doi: 10.1016/j.jvscit.2019.09.006. eCollection 2020 Mar.

Abstract

An Arnold-Chiari malformation is a congenital central nervous system defect. Raised intracranial pressure is commonly observed, and posterior decompression neurosurgery is the treatment of choice. We describe a patient with iatrogenic occlusion of bilateral jugular veins, subclavian vein, and superior vena cava resulting from repeated central venous cannulations. Because of venous hypertension, the patient suffered from neurologic symptoms: headaches, vision disturbances, and marked head edema. Two stents were used to recanalize the right internal jugular vein and superior vena cava. Symptoms subsided, and the patient returned to work. During 24-month follow-up, stents were patent. The patient remains symptom free and continues working.

摘要

阿诺德-奇阿利畸形是一种先天性中枢神经系统缺陷。颅内压升高较为常见,后颅窝减压神经外科手术是首选治疗方法。我们描述了一名患者,因反复进行中心静脉置管导致双侧颈静脉、锁骨下静脉和上腔静脉医源性闭塞。由于静脉高压,该患者出现了神经症状:头痛、视力障碍和明显的头部水肿。使用了两个支架来再通右颈内静脉和上腔静脉。症状缓解,患者恢复工作。在24个月的随访期间,支架保持通畅。患者仍无症状,继续工作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e462/7005334/a8eeb12b0ca8/gr1.jpg

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