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消失的现象:一例左肾静脉支架移位病例

The disappearing act: case of a migrating left renal vein stent.

作者信息

Cooley Christopher, Alexander Robert A, Johns Pradeep, Fanning Thomas, Oommen Jerry Z

机构信息

Department of Emergency Medicine, Corewell Health East - Farmington Hills, Framington Hills, MI, USA.

College of Osteopathic Medicine, Michigan State University College of Osteopathic Medicine, East Lansing, MI, USA.

出版信息

Oxf Med Case Reports. 2023 Aug 20;2023(8):omad090. doi: 10.1093/omcr/omad090. eCollection 2023 Aug.

Abstract

INTRODUCTION

Nutcracker syndrome (NS) is a rare condition in which the abdominal aorta and superior mesenteric artery compress the left renal vein (LRV). One treatment option is the placement of an endovascular stent into the LRV, which carries the risk of stent migration.

CASE REPORT

A 30-year-old female with NS status-post LRV stenting 6 months prior presented to the emergency department with suprapubic pain. An incidental finding on abdominal computed tomography scan noted interval removal of LRV stent, which had not been surgically removed. A subsequent chest radiograph showed the stent lodged in the left pulmonary artery.

DISCUSSION

To our knowledge, this is the first documented case of LRV stent migration to the pulmonary artery. This case demonstrates the importance of physician awareness of stent migration as a potential complication after stent placement, and careful review of all imaging findings, even if unrelated to the chief complaint.

摘要

引言

胡桃夹综合征(NS)是一种罕见疾病,腹主动脉和肠系膜上动脉压迫左肾静脉(LRV)。一种治疗选择是在左肾静脉内放置血管内支架,但存在支架移位风险。

病例报告

一名30岁女性,6个月前接受左肾静脉支架置入术,因耻骨上疼痛就诊于急诊科。腹部计算机断层扫描偶然发现左肾静脉支架已自行脱落,未进行手术取出。随后的胸部X线片显示支架嵌顿于左肺动脉。

讨论

据我们所知,这是左肾静脉支架移位至肺动脉的首例文献记载病例。该病例表明,医生应意识到支架移位是支架置入术后的潜在并发症,并仔细审查所有影像学检查结果,即使与主要症状无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2c7/10451109/a84ed9092c2a/omad090f1.jpg

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