继发于既往胸部弹片伤的肺动静脉瘘：临床表现及介入治疗方法
Pulmonary arteriovenous fistula secondary to historic thoracic shrapnel injury: presenting features and interventional approach.
作者信息
Chiswell Kate, Al-Hindawi Ahmed, Dunn Richard, Waugh Richard, Cordina Rachael
机构信息
Royal Prince Alfred Hospital, 50 Missenden Road, Camperdown, NSW, Australia.
Department of Radiology, Royal Prince Alfred Hospital, Sydney, Australia.
出版信息
CVIR Endovasc. 2025 Apr 14;8(1):30. doi: 10.1186/s42155-024-00494-y.
BACKGROUND
A chronic pulmonary arteriovenous fistula (PAVF) post penetrating thoracic injury is rare; this case demonstrates the presentation, diagnostic implications and a successful endovascular approach to close it.
CASE PRESENTATION
We report the case of a rare pulmonary arteriovenous fistula in a 50-year-old man secondary to historic thoracic shrapnel injury. He had a positive bubble study on echocardiography; CT pulmonary angiogram identified a pulmonary arteriovenous fistula. He underwent successful repair with an endovascular approach.
CONCLUSION
PAVF can result from penetrating chest trauma. An intra-pulmonary shunt should be suspected in the setting of hypoxaemia refractory to oxygen therapy and when there is no evidence of an intra-cardiac shunt. Endovascular intervention can facilitate definitive treatment by employing a plug-in-stent technique.
背景
穿透性胸部损伤后发生慢性肺动静脉瘘（PAVF）较为罕见；本病例展示了其临床表现、诊断意义及成功的血管内封堵治疗方法。
病例介绍
我们报告一例50岁男性因既往胸部弹片伤继发罕见肺动静脉瘘的病例。他的超声心动图气泡试验呈阳性；CT肺血管造影显示有肺动静脉瘘。他通过血管内治疗方法成功修复。
结论
PAVF可由穿透性胸部创伤引起。在氧疗难以纠正的低氧血症且无心脏内分流证据的情况下，应怀疑存在肺内分流。血管内介入治疗可采用带膜支架技术促进确定性治疗。
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