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血管内修复与开放修复联合治疗锁骨下动脉损伤

Combination of endovascular and open repair for the management of subclavian artery injury.

作者信息

Barmparessos Emmanouil, Katsikas Vasileios, Gravanis Miltiadis, Kalamaras Alexios, Kopadis George

机构信息

Vascular Surgery Department, General Hospital of Athens "Georgios Gennimatas", 154 Mesogeion Avenue, 156 69 Athens, Greece.

Interventional Radiology Department, General Hospital of Athens "Georgios Gennimatas", 154 Mesogeion Avenue, 156 69 Athens, Greece.

出版信息

Trauma Case Rep. 2022 Jul 6;41:100673. doi: 10.1016/j.tcr.2022.100673. eCollection 2022 Oct.

Abstract

Axillosubclavian artery injury is relatively uncommon; however, it is related to a high rate of morbidity and mortality. Although open repair as well as endovascular techniques have been proposed for the treatment of axillosubclavian artery injury, the ideal approach is still under investigation. We present a case of a 20-year-old patient who suffered from complete subclavian artery transection, following blunt thoracic trauma. Using percutaneous access, a balloon catheter was inflated under fluoroscopy, in the origin of his affected subclavian artery ceasing the haemorrhage, thus immediately afterwards he was submitted to arterial bypass. The combination of endovascular and open repair ensured his life and limb salvage while the complications of an otherwise extensive dissection were obviated.

摘要

腋锁骨下动脉损伤相对少见;然而,其与高发病率和死亡率相关。尽管已提出开放修复以及血管腔内技术用于治疗腋锁骨下动脉损伤,但理想的治疗方法仍在研究中。我们报告一例20岁患者,其在钝性胸部创伤后发生锁骨下动脉完全横断。通过经皮穿刺,在透视引导下对球囊导管进行充气,在其患侧锁骨下动脉起始部止血,随后立即对其进行动脉搭桥术。血管腔内修复与开放修复相结合确保了患者生命及肢体的挽救,同时避免了原本广泛解剖所带来的并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8e8/9283655/3f21bea18eec/gr1.jpg

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