Shannon Nicholas Brian, Kumar Pradesh, Tay Kiang Hiong, Tan Sia Yang, Chng Siew Ping, Tay Hsien Tsung
Department of Vascular and Endovascular Surgery, Singapore General Hospital, Singapore.
Department of Vascular and Interventional Radiology, Singapore General Hospital, Singapore.
SAGE Open Med Case Rep. 2020 Feb 10;8:2050313X20906741. doi: 10.1177/2050313X20906741. eCollection 2020.
A 79-year-old Chinese gentleman presented with unilateral acute lower limb ischaemia and received intra-arterial catheter-directed thrombolysis, initially with good result and reversal of the ischaemia. However, he developed an extensive spontaneous spinal epidural haematoma within hours of the procedure and was left with permanent paraplegia after being deemed unsuitable for decompressive spinal surgery. This report serves as a reminder of the risk of severe complications of catheter-directed thrombolysis by describing this rare but devastating side-effect that occurred even despite early detection from onset of symptoms.
一位79岁的中国男性患者出现单侧急性下肢缺血,接受了动脉内导管定向溶栓治疗,最初效果良好,缺血症状得到缓解。然而,在治疗后数小时内,他出现了广泛的自发性脊髓硬膜外血肿,由于被认为不适合进行减压性脊柱手术,最终导致永久性截瘫。本报告通过描述这种罕见但具有毁灭性的副作用,提醒人们注意导管定向溶栓治疗严重并发症的风险,尽管从症状出现时就进行了早期检测,但仍发生了这种情况。