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一名右锁骨下动脉异常患者经桡动脉冠状动脉造影术后发生医源性主动脉夹层。

Iatrogenic aortic dissection following transradial coronary angiography in a patient with an aberrant right subclavian artery.

作者信息

Wang Peijian, Wang Qiulin, Bai Chen, Zhou Peng

机构信息

Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, China.

Department of Imaging, The First Affiliated Hospital, Chengdu Medical College, Chengdu, Sichuan, China.

出版信息

J Int Med Res. 2020 Aug;48(8):300060520943789. doi: 10.1177/0300060520943789.

Abstract

An aberrant right subclavian artery is a congenital aortic arch anomaly in which the right subclavian artery originates from the proximal descending aorta. The presence of an aberrant right subclavian artery can make right transradial coronary interventions more difficult and even lead to complications. Iatrogenic intramural hematomas and dissection of aberrant right subclavian arteries during transradial coronary angiography have been previously reported. We herein report a case of iatrogenic aortic dissection following attempts to perform right transradial coronary angiography in a patient with an aberrant right subclavian artery. Clinicians should be vigilant for the presence of an aberrant right subclavian artery during right transradial coronary angiography and ensure gentle manipulation of wires and catheters to avoid complications.

摘要

迷走右锁骨下动脉是一种先天性主动脉弓异常,其中右锁骨下动脉起源于近端降主动脉。迷走右锁骨下动脉的存在会使经桡动脉右侧冠状动脉介入操作更加困难,甚至导致并发症。此前已有经桡动脉冠状动脉造影术中迷走右锁骨下动脉发生医源性壁内血肿和夹层的报道。我们在此报告一例在一名患有迷走右锁骨下动脉的患者尝试进行经桡动脉右侧冠状动脉造影后发生医源性主动脉夹层的病例。临床医生在经桡动脉右侧冠状动脉造影期间应警惕迷走右锁骨下动脉的存在,并确保轻柔操作导丝和导管以避免并发症。

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