Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan.
Department of Urology, St. Marianna University School of Medicine, Japan.
Intern Med. 2024 Aug 15;63(16):2307-2310. doi: 10.2169/internalmedicine.2990-23. Epub 2024 Jan 13.
A 41-year-old woman diagnosed with seronegative myasthenia gravis struggled to maintain remission for a decade, facing crises every 3 months for several years. After repeated apheresis using a non-tunneled non-cuffed central venous dialysis catheter (NTNCC), complications such as catheter-related thrombus in the internal jugular veins and morbid obesity from steroids made the insertion of NTNCC increasingly difficult, leading to consideration of an alternative permanent vascular access (VA) approach. Thus, we created a subcutaneously superficialized brachial artery as the VA, which allowed the patient to undergo safe and uninterrupted apheresis therapy.
一位 41 岁的女性被诊断患有血清阴性重症肌无力，经过十年的努力才维持缓解状态，但在过去几年中每 3 个月都会面临一次危机。在多次使用无隧道无袖带中心静脉透析导管（NTNCC）进行血浆置换后，该患者出现了一些并发症，如颈内静脉导管相关血栓形成，以及类固醇引起的病态肥胖，这使得 NTNCC 的插入变得越来越困难，因此我们考虑采用另一种永久性血管通路（VA）方法。于是，我们创建了皮下化肱动脉作为 VA，使患者能够安全、不间断地进行血浆置换治疗。
