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颈动脉支架感染的外科治疗:一例报告

Surgical treatment of carotid artery stent infection: a case report.

作者信息

Liu Xiwen, Zhao Yue, Zhao Fucheng, Guo Suli, Sun Daju

机构信息

Department of Vascular Surgery, China-Japan Union Hospital of 12510Jilin University, Changchun, China.

出版信息

J Int Med Res. 2021 Feb;49(2):300060520987081. doi: 10.1177/0300060520987081.

Abstract

The most effective treatment for graft infection is still debated, and the success rate of current treatments is low. We herein report the results of surgical treatment and follow-up of a case of infection acquired during carotid stenting with the aim of exploring the most effective treatments for graft infection. We retrospectively analyzed a patient who was admitted in September 2019. This patient underwent debridement, autologous saphenous vein replacement of the common carotid to internal carotid artery, external carotid artery suturing, and continuous negative-pressure wound therapy for carotid stent infection. Ten days after carotid artery revascularization, the growth of granulation tissue in the incision was good, and we decided to suture the neck incision. Five days after removing the stitches, grade A healing was noted. Furthermore, the carotid artery and autologous vein grafts were unobstructed as shown by carotid artery computed tomography angiography reexamination. The patient was monitored for 8 months with no new neurological symptoms and good healing of the incision. Effective treatment of vascular graft infection includes debridement and removal of the infected graft, autologous vein graft revascularization, and negative-pressure wound therapy combined with antibiotic therapy.

摘要

移植物感染的最有效治疗方法仍存在争议,目前治疗的成功率较低。我们在此报告一例颈动脉支架置入术中获得性感染的手术治疗及随访结果,旨在探索移植物感染的最有效治疗方法。我们回顾性分析了一名于2019年9月入院的患者。该患者接受了清创术、自体大隐静脉置换颈总动脉至颈内动脉、颈外动脉缝合以及针对颈动脉支架感染的持续负压伤口治疗。颈动脉血运重建术后10天,切口肉芽组织生长良好,我们决定缝合颈部切口。拆线后5天,切口甲级愈合。此外,颈动脉计算机断层血管造影复查显示颈动脉和自体静脉移植物通畅。对该患者进行了8个月的监测,未出现新的神经症状,切口愈合良好。血管移植物感染的有效治疗包括清创和去除感染的移植物、自体静脉移植物血运重建以及负压伤口治疗联合抗生素治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e460/7876762/85aedb02d24b/10.1177_0300060520987081-fig1.jpg

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