- 期刊
Radial Arteriovenous Fistula: A Rare Complication of Coronary Angiography by Transradial Approach
動靜脈廔管：經橈動脈心導管術的罕見血管併發症
摘要
經股動脈或經橈動脈心導管術已成為心臟科醫師慣用的冠狀動脈攝影及冠狀動脈成形術。經橈動脈心導管術之優點包括較低的血管併發症，並且允許患者較早下床活動。經橈動脈心導管術的血管併發症，譬如血腫、橈動脈阻塞、痙攣、假性瘤都已經被報告了。動靜脈廔管是經股動脈或經上臂動脈公認的血管併發症之一，但對於經橈動脈心導管術則是極為罕見的血管併發症。因此，我們報告一位六十七歲男性病患，經橈動脈心導管術後兩個月，發現動靜脈廔管之個案。瀰漫性左上臂疼痛，橈動脈入針處明顯的震顫為其臨床表現。確切診斷則靠杜卜勒超音波及血管攝影。由於臨床症狀約發生經橈動脈心導管術後一到兩個月內，故認為其屬於晚期併發症。當病患經橈動脈心導管術後一到兩個月主訴瀰漫性上臂疼痛，臨床醫師應小心排除動靜脈廔管的可能，因早期診斷和治療計劃的安排，對經橈動脈心導管成形術尤其重要。
並列摘要
Transfemoral or transradial approach for coronary angiography of angioplasty is the norm for most cardiologists. Transradial approach is well known for its low rate of vascular complications and also allows early ambulation of patients. Access site complications, such as hematoma, radial artery occlusion, spasm and pseudoaneurysm, have been reported. Arteriovenous fistula (AVF) is a well-recognized complication of femoral or brachial approach, but it is an extremely rare complication for transradial approach. We report a 67-year-old man who underwent angioplasty via transradial approach and then two months later suffered from diffuse pain over his left forearm with palpable thrill at the left radial puncture site. Subsequent Doppler ultrasound imaging and angiography demonstrated an AVF. This late complication emphasizes the need for meticulous attention when diffuse forearm pain develops after transradial approach. This could be important for physicians in early detection and therapeutic planning for patient after percutaneous coronary intervention.