尺动脉入路冠状动脉介入治疗的骨筋膜室综合征并发症
Compartment Syndrome Complication of Coronary Intervention Using Ulnar Artery Access.
作者信息
Couturier Marie Isabelle, Bejugam Deeptha, Blay Ernesto K, Seals A Allen
机构信息
London School of Hygiene and Tropical Medicine, London, United Kingdom.
Georgetown University Medical School, Washington, District of Columbia, USA.
出版信息
JACC Case Rep. 2025 Jun 4;30(13):104247. doi: 10.1016/j.jaccas.2025.104247.
BACKGROUND
Compartment syndrome (CS) is a rare complication from ulnar artery access for coronary intervention.
CASE SUMMARY
An 84-year-old patient presented with acute coronary syndrome. Coronary intervention was performed using ulnar artery access after radial access was found to be unsuitable. Post-procedure, upper extremity hematoma progressed to CS. Surgical fasciotomy and ulnar artery repair was successful, but neurologic impairment remained.
DISCUSSION
This patient represents a unique case of coronary intervention using ulnar artery access with resultant complications of hematoma and progression to CS. In this case, the multitude of vascular risk factors probably contributed to this complication. Early CS recognition by symptoms and examination was assisted by vascular ultrasound. Prompt surgical intervention with evacuation of the hematoma and arterial repair prevented tissue necrosis or possible amputation; however, lingering nerve damage remained.
TAKE-HOME MESSAGE: Early recognition and appropriate management of ulnar artery-related CS is critical to minimize long-term complications.
背景
骨筋膜室综合征（CS）是冠状动脉介入治疗中经尺动脉穿刺的一种罕见并发症。
病例摘要
一名84岁患者出现急性冠状动脉综合征。在发现经桡动脉穿刺不合适后，采用经尺动脉穿刺进行冠状动脉介入治疗。术后，上肢血肿进展为骨筋膜室综合征。手术切开筋膜减压和尺动脉修复成功，但神经功能障碍仍然存在。
讨论
该患者是经尺动脉穿刺进行冠状动脉介入治疗并导致血肿及进展为骨筋膜室综合征的独特病例。在本病例中，多种血管危险因素可能导致了这一并发症。血管超声有助于通过症状和检查早期识别骨筋膜室综合征。及时进行手术干预，清除血肿并修复动脉，防止了组织坏死或可能的截肢；然而，神经损伤仍然存在。
经验教训
早期识别和适当处理与尺动脉相关的骨筋膜室综合征对于将长期并发症降至最低至关重要。
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