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医源性锁骨下动脉损伤修复过程中封堵球囊被ProGlide封堵器卡住。

ProGlide entrapment of the occlusive balloon during repair of an iatrogenic subclavian artery injury.

作者信息

Kemp Benjamin Jr, Kearns Daniel J, Uberoi Raman

机构信息

Oxford University Hospitals, Oxford, United Kingdom.

出版信息

BJR Case Rep. 2023 Sep 12;9(5):20230015. doi: 10.1259/bjrcr.20230015. eCollection 2023 Oct.

Abstract

The insertion of any central venous catheter (CVC) is associated with a risk of damage to neurovascular structures, pneumothorax, cardiac arrhythmias, and infection. Unintentional arterial puncture remains rare, occurring in 6.3-9.4% of attempted internal jugular vein (IJV) catheterisation and 3.1-4.9% of attempted subclavian vein catheterisation. We present a previously undocumented complication encountered while utilising the Perclose ProGlide device in the case of a 59-year-old male who underwent right subclavian artery closure following the accidental insertion of a 14Fr Vascath into the right subclavian artery. This was performed using two ProGlide devices and one Angio-Seal device. Following deployment of the ProGlide devices, an uninflated balloon passed into the subclavian artery as a precaution, but not used, was removed. One of the ProGlide devices became dislodged having been deployed into the balloon, threatening haemostasis.

摘要

插入任何中心静脉导管(CVC)都有损伤神经血管结构、导致气胸、心律失常和感染的风险。意外动脉穿刺仍然很少见,在尝试颈内静脉(IJV)置管的病例中发生率为6.3 - 9.4%,在尝试锁骨下静脉置管的病例中发生率为3.1 - 4.9%。我们报告了一例此前未记录的并发症,一名59岁男性在意外将一根14Fr Vascath导管插入右锁骨下动脉后,使用Perclose ProGlide装置进行右锁骨下动脉闭合时发生了该并发症。这一操作使用了两个ProGlide装置和一个Angio - Seal装置。在部署ProGlide装置后,一个未充气的球囊作为预防措施进入了锁骨下动脉,但未使用就被取出。其中一个ProGlide装置在部署到球囊后发生移位,危及止血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8be7/10513006/f74e080863c6/bjrcr.20230015.g001.jpg

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