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胸壁肿瘤切除术中遇到的腋动脉损伤

Axillary Artery Injury Encountered During Chest Wall Tumor Resection.

作者信息

Umeda Yukio, Hagiwara Kiyohiko, Matsumoto Shinsuke

机构信息

Cardiovascular and Thoracic Surgery, Gifu Prefectural General Medical Center, Gifu, JPN.

出版信息

Cureus. 2024 Aug 29;16(8):e68144. doi: 10.7759/cureus.68144. eCollection 2024 Aug.

DOI:10.7759/cureus.68144
PMID:39359570
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11445979/
Abstract

Axillary artery injuries are rare because of their anatomy but are sometimes fatal because of the difficulty of obtaining vascular integrity. We report a 50-year-old patient with an iatrogenic axillary arterial injury that occurred during the resection of a chest wall tumor. The injury occurred during an incision of the intercostal muscle along the superior margin of the second rib. Following primary hemostasis achieved by forceps and amputation of the pectoralis minor muscle, the injury site was exposed sufficiently and successfully repaired by a vascular surgeon. This successful case provided valuable insight into strategies, primary hemostasis, and subsequent revascularization for an intraoperative vascular injury.

摘要

由于腋动脉的解剖结构,其损伤较为罕见,但由于难以实现血管完整性,有时会导致致命后果。我们报告了一名50岁患者,在切除胸壁肿瘤时发生了医源性腋动脉损伤。损伤发生在沿第二肋上缘切开肋间肌的过程中。通过镊子实现初步止血并切除胸小肌后,损伤部位得到充分暴露,并由血管外科医生成功修复。这个成功案例为术中血管损伤的处理策略、初步止血及后续血管重建提供了宝贵的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc95/11445979/366f5dc942b9/cureus-0016-00000068144-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc95/11445979/84bf263ffada/cureus-0016-00000068144-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc95/11445979/53d255b65947/cureus-0016-00000068144-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc95/11445979/366f5dc942b9/cureus-0016-00000068144-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc95/11445979/84bf263ffada/cureus-0016-00000068144-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc95/11445979/53d255b65947/cureus-0016-00000068144-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc95/11445979/366f5dc942b9/cureus-0016-00000068144-i03.jpg

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Am J Case Rep. 2023 Dec 21;24:e942123. doi: 10.12659/AJCR.942123.
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Endovascular repair of traumatic axillary artery transection associated with scapulothoracic dissociation complicated by stent separation.
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J Vasc Surg Cases Innov Tech. 2023 Jan 24;9(1):101110. doi: 10.1016/j.jvscit.2023.101110. eCollection 2023 Mar.
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Am J Surg. 2022 Dec;224(6):1385-1387. doi: 10.1016/j.amjsurg.2022.10.034. Epub 2022 Oct 17.
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