van Heeckeren D W, Botti R E, Cohen A M
Am J Cardiol. 1979 Sep;44(3):566-8. doi: 10.1016/0002-9149(79)90413-2.
Arteriovenous fistula of the innominate artery occurred in a patient 3 weeks after retrograde brachial arterial catheterization was performed 1 day before aortocoronary bypass surgery. Intramural dissection was noted at catheterization, and a mediastinal hematoma at operation. Exploration of the hematoma in the course of catheterization might have prevented the arteriovenous fistula, which necessitated a second operation 3 weeks after the first. To our knowlege this complication of retrograde brachial catheterization has not previously been described. We recommend that known injuries to cervical or thoracic arteries occurring just before operations requiring extracorporeal circulation be explored to prevent late complications. Recent injuries to the cervical and thoracic arteries that are not acessible to external compression should be exposed and treated during sternotomy to prevent late complications if heparinization is contemplated.
无名动脉动静脉瘘发生在一名患者身上，该患者在主动脉冠状动脉搭桥手术前1天进行了逆行肱动脉插管，3周后出现此情况。插管时发现壁内剥离，手术时发现纵隔血肿。在插管过程中对血肿进行探查可能会预防动静脉瘘的发生，而动静脉瘘使得在第一次手术后3周又需要进行第二次手术。据我们所知，此前尚未有过关于逆行肱动脉插管这种并发症的描述。我们建议，对于在需要体外循环的手术前刚发生的已知颈或胸段动脉损伤进行探查，以预防晚期并发症。对于无法通过外部压迫处理的近期颈和胸段动脉损伤，如果考虑进行肝素化，应在胸骨切开术期间进行暴露和处理，以预防晚期并发症。
