Zhui Li, Chuli Jiang, Yangyang Feng, Yu Zhao, Wei Ren
Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, CHN.
Cureus. 2024 Mar 10;16(3):e55885. doi: 10.7759/cureus.55885. eCollection 2024 Mar.
Recurrence of a lung tumor invading the subclavian artery, causing stenosis and leading to finger ulcers as the initial symptom, is rare. We employed endovascular techniques, inserting a Viabahn® VBX covered stent (W. L. Gore & Associates, Flagstaff, Arizona) to aid in ulcer healing and improve the patient's quality of life. The patient, a 73-year-old male, had a history of lung adenocarcinoma resection two years prior but had not undergone follow-up examinations or cancer-specific treatments. Clinical examination revealed an invasion of the right subclavian artery by the recurrent tumor, resulting in severe stenosis and ischemic symptoms in the right upper limb. Given the patient's advanced cancer stage and the decline of further tumor-specific treatments, an endovascular intervention using a Viabahn VBX covered stent was performed to improve blood flow and promote ulcer healing. The stent demonstrated exceptional stability and patency during the six-month follow-up, greatly improving the patient's quality of life. This case highlights the importance of recognizing atypical symptoms as potential indicators of tumor recurrence or progression and demonstrates the promising role of covered stents in managing vascular complications in selected patients with advanced-stage malignancies.
肺肿瘤复发侵犯锁骨下动脉,导致狭窄并以手指溃疡为首发症状,这种情况很罕见。我们采用血管内技术,植入了Viabahn® VBX覆膜支架(美国亚利桑那州弗拉格斯塔夫市的W. L. Gore & Associates公司生产),以促进溃疡愈合并改善患者生活质量。该患者为73岁男性,两年前有肺腺癌切除病史,但未进行随访检查或癌症特异性治疗。临床检查发现复发性肿瘤侵犯右锁骨下动脉,导致右上肢严重狭窄和缺血症状。鉴于患者癌症晚期且进一步的肿瘤特异性治疗效果不佳,遂进行血管内介入治疗,植入Viabahn VBX覆膜支架以改善血流并促进溃疡愈合。在六个月的随访期间,支架显示出卓越的稳定性和通畅性,极大地改善了患者的生活质量。该病例强调了将非典型症状识别为肿瘤复发或进展潜在指标的重要性,并展示了覆膜支架在治疗部分晚期恶性肿瘤患者血管并发症方面的良好前景。