Liao Jianyu, Ma YuKui, Wu Zhoupeng, Wang Xinyan, Zhao Jichun
Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China.
Front Cardiovasc Med. 2025 Apr 28;12:1532300. doi: 10.3389/fcvm.2025.1532300. eCollection 2025.
This case report discussed a 43-year-old female who underwent multiple radiotherapy sessions after cervical cancer surgery and experienced serious complications due to simultaneous iliac vein stent placement immediately after thrombus aspiration without adequate evaluation of the indication for stent placement. Two months after radiotherapy, the patient developed right lower limb edema and pain, which led to the discovery of an iliac vein thrombosis. Subsequent stent placement without thorough evaluation resulted in severe complications, including infection and sepsis. Despite initial symptom relief, the patient was readmitted with high fever and severe pain, and imaging revealed gas around the stent, indicating infection. An exploratory laparotomy uncovered a large abscess and a colonic fistula. The stents were removed, and the patient underwent aggressive anti-infection treatment involving meropenem and vancomycin, along with surgical repair of the fistula. This case highlights the importance of accurate diagnosis and careful consideration of stent placement in preventing severe outcomes, including the rare but serious risk of venous stent infections requiring surgical intervention.
本病例报告讨论了一名43岁女性，她在宫颈癌手术后接受了多次放疗，并在血栓抽吸后立即同时放置髂静脉支架，而未对支架置入指征进行充分评估，从而出现了严重并发症。放疗两个月后，患者出现右下肢水肿和疼痛，随后发现髂静脉血栓形成。随后未经全面评估就进行支架置入导致了严重并发症，包括感染和脓毒症。尽管最初症状有所缓解，但患者因高热和剧痛再次入院，影像学检查显示支架周围有气体，提示感染。剖腹探查发现一个大脓肿和一个结肠瘘。取出支架后，患者接受了美罗培南和万古霉素的积极抗感染治疗，并进行了瘘管手术修复。本病例强调了准确诊断和谨慎考虑支架置入在预防严重后果中的重要性，包括罕见但严重的静脉支架感染风险，这种感染需要手术干预。
