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抽吸辅助经皮静脉清除危重症患者右心房血栓的应用:病例报告及临床管理概述

Application of Aspiration-Assisted Percutaneous Venous Removal of Right Atrial Thrombus in a Critically Ill Patient: A Case Study and Clinical Management Overview.

作者信息

Alam Khan, Pendlebury Gehan A, Oro Peter, McAlister James, Hashmi Tahreem, Ijaz Hasnan M, Chaudhry Ali, Ergle Kevin

机构信息

Internal Medicine, Westside Regional Medical Center, Plantation, USA.

Dermatology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA.

出版信息

Cureus. 2022 Sep 6;14(9):e28852. doi: 10.7759/cureus.28852. eCollection 2022 Sep.

Abstract

We herein present a complex case of a 50-year-old female with catheter-related atrial thrombus (CRAT). This patient with end-stage renal disease on hemodialysis presented with angioedema leading to respiratory failure. She was subsequently intubated, and the pre-procedural course was complicated by a cardio-respiratory arrest, and anoxic brain injury. The patient's hemodialysis catheter placement in the superior vena cava (SVC) potentially correlated with the development of the right atrial thrombus. The patient was treated percutaneously as she presented with complex morbidities. The mass was successfully removed via aspiration-assisted percutaneous right heart bypass, a procedure that utilizes a vacuum system to remove thrombi. Post-procedure, the patient remained stable and continued supervised care.

摘要

我们在此报告一例50岁女性导管相关性心房血栓(CRAT)的复杂病例。该患有终末期肾病且正在接受血液透析的患者出现血管性水肿,进而导致呼吸衰竭。随后她接受了插管,术前过程因心肺骤停和缺氧性脑损伤而复杂化。患者上腔静脉(SVC)内的血液透析导管置入可能与右心房血栓的形成有关。由于患者存在复杂的病症,故采用经皮治疗。通过抽吸辅助经皮右心旁路术成功移除了血栓,该手术利用真空系统清除血栓。术后,患者保持稳定并继续接受监护。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab74/9491628/519b5d052c12/cureus-0014-00000028852-i01.jpg

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