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一名血液透析患者复发性导管相关右心房血栓形成：病例报告及文献综述

Recurrent catheter-related right atrial thrombosis in a hemodialysis patient: A case report and literature review.

作者信息

Li Lu, Fu Huaying, Chen Tienan, Wang Lihua

机构信息

Department of Kidney Disease and Blood Purification Centre, 2nd Hospital of Tianjin Medical University, 23rd, Pingjiang Road, Hexi District, Tianjin, PR China, 300211.

Department of Cardiology, 2nd Hospital of Tianjin Medical University, 23rd, Pingjiang Road, Hexi District, Tianjin, PR China, 300211.

出版信息

Radiol Case Rep. 2025 Sep 15;20(12):6003-6010. doi: 10.1016/j.radcr.2025.08.073. eCollection 2025 Dec.

DOI:10.1016/j.radcr.2025.08.073
PMID:41019959
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12464686/
Abstract

Right atrial thrombus is an uncommon yet potentially life-threatening complication associated with central venous catheterization. We report an unusual case of catheter-associated right atrial thrombosis (CRAT) in a patient receiving maintenance hemodialysis, who presented with recurrent thrombus on the fifth day following surgical thrombectomy. This report summarizes the clinical presentation, diagnostic modalities, and management strategies for CRAT. Our intention is to improve clinicians' awareness of this complication and provide practical insights into optimal management in hemodialysis patients.

摘要

右心房血栓是一种与中心静脉置管相关的罕见但可能危及生命的并发症。我们报告了一例接受维持性血液透析患者发生的导管相关性右心房血栓形成（CRAT）的不寻常病例，该患者在手术取栓术后第五天出现复发性血栓。本报告总结了CRAT的临床表现、诊断方法和管理策略。我们的目的是提高临床医生对这种并发症的认识，并为血液透析患者的最佳管理提供实用见解。

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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67b2/12464686/027a86ad9930/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67b2/12464686/fc0ae40276d6/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67b2/12464686/8bf62a6f9102/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67b2/12464686/6da339883fda/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67b2/12464686/0a71975d584a/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67b2/12464686/24b0869fbfe6/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67b2/12464686/4358538e85b1/gr8.jpg

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本文引用的文献

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Cardiac Computed Tomography for Cardioembolic Stroke Evaluation in a Patient With a Mechanical Aortic Valve.心脏计算机断层扫描在机械主动脉瓣患者心源性栓塞性卒中评估中的应用
JACC Case Rep. 2024 Sep 18;29(18):102524. doi: 10.1016/j.jaccas.2024.102524.
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Catheter-Related Right Atrial Thrombus Requiring Surgical Embolectomy.需要手术取栓的导管相关右心房血栓
Cureus. 2021 Sep 1;13(9):e17641. doi: 10.7759/cureus.17641. eCollection 2021 Sep.
3
Predictive Value of Cardiac CTA, Cardiac MRI, and Transthoracic Echocardiography for Cardioembolic Stroke Recurrence.
心脏 CT 血管造影、心脏 MRI 和经胸超声心动图对心源性卒中复发的预测价值。
AJR Am J Roentgenol. 2021 Aug;217(2):336-346. doi: 10.2214/AJR.20.23903. Epub 2021 Jun 16.
4
How to manage catheter-related right atrial thrombosis: Our conservative approach.如何管理导管相关的右心房血栓：我们的保守方法。
J Vasc Access. 2021 May;22(3):480-484. doi: 10.1177/1129729820922703. Epub 2020 May 15.
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Catheter-related right atrial thrombosis.导管相关的右心房血栓形成。
J Vasc Access. 2020 May;21(3):300-307. doi: 10.1177/1129729819873851. Epub 2019 Sep 25.
6
Management of tunneled-cuffed catheter-related right atrial thrombosis in hemodialysis patients.血液透析患者隧道式带 cuff 导管相关右心房血栓的管理
J Vasc Surg. 2018 Nov;68(5):1491-1498. doi: 10.1016/j.jvs.2018.02.039. Epub 2018 May 24.
7
Is the removal of a central venous catheter always necessary in the context of catheter-related right atrial thrombosis?在与导管相关的右心房血栓形成的情况下，是否总是需要拔除中心静脉导管？
J Vasc Access. 2019 Jan;20(1):98-101. doi: 10.1177/1129729818774438. Epub 2018 May 11.
8
Catheter-related atrial thrombus: tip of the iceberg?导管相关心房血栓：冰山一角？
Ren Fail. 2015 May;37(4):567-71. doi: 10.3109/0886022X.2015.1007461. Epub 2015 Feb 19.
9
Right atrial thrombosis associated with hemodialysis catheter: first description of recurrence in a poorly understood problem.与血液透析导管相关的右心房血栓形成：对一个了解甚少的问题中复发情况的首次描述。
J Thromb Thrombolysis. 2015 Feb;39(2):254-7. doi: 10.1007/s11239-014-1115-0.
10
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Nephrol Dial Transplant. 2012 Jul;27(7):2936-44. doi: 10.1093/ndt/gfr739. Epub 2011 Dec 20.