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植入式心脏复律除颤器植入术后肱静脉深静脉血栓形成:一位家庭医生的观点。

Deep Vein Thrombosis in the Humeral Vein After Implantable Cardioverter-Defibrillator Implantation: A Family Physician's Perspective.

作者信息

Alves Pedro, Silva João, Ribeiro João, Moreira Sónia

机构信息

Family Medicine, USF (Unidade de Saude Familiar) Tâmega, Administração Regional de Saúde do Norte, Porto, PRT.

Family Medicine, USF (Unidade de Saude Familiar) Alpendorada, Administração Regional de Saúde do Norte, Porto, PRT.

出版信息

Cureus. 2023 Dec 20;15(12):e50827. doi: 10.7759/cureus.50827. eCollection 2023 Dec.

DOI:10.7759/cureus.50827
PMID:38249257
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10797848/
Abstract

Upper extremity deep vein thrombosis (DVT) is an uncommon, under-reported, and difficult-to-diagnose condition. Although the strong provoking risk factors of venous thromboembolism are well described in the literature, the majority of cases are provoked by weak risk factors or are even considered unprovoked. In this case report, we describe a rare case of a brachial DVT in a woman in her 40s following implantable cardioverter-defibrillator (ICD) implantation. In her first evaluation, slight left arm edema and brachialgia were noted, and physiotherapy was prescribed. One month later, the patient was reevaluated because her complaints did not resolve, and an upper extremity venous ultrasound was done to exclude complications due to ICD implantation. The ultrasound identified an old DVT, which had been completely recanalized. The patient was then referred to a vascular surgery specialty consultation, which confirmed the diagnosis, and an anticoagulant was prescribed for three months. The symptoms resolved, and the patient did not report any more pain.

摘要

上肢深静脉血栓形成(DVT)是一种罕见、报告不足且难以诊断的疾病。尽管静脉血栓栓塞的强烈诱发危险因素在文献中已有详尽描述,但大多数病例是由微弱危险因素诱发的,甚至被认为是无诱因的。在本病例报告中,我们描述了一例罕见的40多岁女性在植入植入式心脏复律除颤器(ICD)后发生肱静脉DVT的病例。在首次评估时,发现左臂轻度水肿和臂痛,并给予了物理治疗。一个月后,由于患者的症状未缓解,对其进行了重新评估,并进行了上肢静脉超声检查以排除ICD植入引起的并发症。超声检查发现了一个已完全再通的陈旧性DVT。随后患者被转诊至血管外科专科会诊,会诊确认了诊断,并开具了为期三个月的抗凝药物。症状得到缓解,患者未再报告任何疼痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7316/10797848/bda7596ce01e/cureus-0015-00000050827-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7316/10797848/bda7596ce01e/cureus-0015-00000050827-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7316/10797848/bda7596ce01e/cureus-0015-00000050827-i01.jpg

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本文引用的文献

1
Implantation of Implantable Cardioverter Defibrillators in Kazakhstan.在哈萨克斯坦植入植入式心脏除颤器。
Glob Heart. 2022 May 10;17(1):30. doi: 10.5334/gh.1119. eCollection 2022.
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Venous thromboembolism.静脉血栓栓塞症。
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Venous thromboembolism in patients with implantable cardioverter-defibrillators.植入式心脏复律除颤器患者的静脉血栓栓塞症。
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Thrombosis: a major contributor to global disease burden.血栓形成:全球疾病负担的主要促成因素。
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Contemporary pacemaker and ICD lead management: techniques for lead extraction.当代起搏器和植入式心律转复除颤器导线管理:导线拔除技术
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Permanent pacemaker-related upper extremity deep vein thrombosis: a series of 20 cases.永久性起搏器相关上肢深静脉血栓形成:20例病例系列
Pacing Clin Electrophysiol. 2012 Oct;35(10):1194-8. doi: 10.1111/j.1540-8159.2012.03467.x. Epub 2012 Jul 21.
9
Prevention of venous thrombosis by warfarin after permanent transvenous leads implantation in high-risk patients.高危患者永久性经静脉导线植入术后华法林预防静脉血栓形成
Pacing Clin Electrophysiol. 2009 Mar;32 Suppl 1:S247-51. doi: 10.1111/j.1540-8159.2008.02295.x.
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Venous obstruction after pacemaker implantation.起搏器植入后的静脉阻塞
Pacing Clin Electrophysiol. 2007 Feb;30(2):199-206. doi: 10.1111/j.1540-8159.2007.00650.x.