- 期刊
Endovascular Repair of Iatrogenic Subclavian Artery Perforations Using Stent-Graft: Report of a Case
以鎖骨下動脈損傷經包覆醫源性支架術血管內修補：病例報告
摘要
一個54歲的中年人因爲醫源性的鎖骨下動脈穿孔併出血而住院，但以血管內支架修復術成功地修復了損傷的鎖骨下動脈。鎖骨下動脈損傷很罕見。最常見的是穿透性外傷導致。相較於血管內支架修復術，傳統外科于術在因外傷或醫源性導致的鎖骨下動脈損傷需要比較複雜的技術且有較高的死亡率及併發症。相對地，血管內支架修復術在技術上可行性比較高，且較安全及可以縮短病人的住院天數。治療雖告成功，定期持續的追蹤及評估病人的血管內修復狀況是必要的。
關鍵字
無資料並列摘要
Purpose: To report a case of iatrogenic subclavian artery perforation treated with Vascular Stent-Graft.Case Report: A 54-year-old married male was admitted to Chung Shin Hospital with the chief complaint of severe sharp pain in his right clavicular region after a traffic accident on April 6, 2009. Fracture of the right clavicle was diagnosed after X-ray examination. The patient immediately underwent open reduction and internal fixation (ORIF) with a Kirschner wire with an uneventful postoperative course. The K-wire was removed 4 weeks later, on May 8, 2009. However, pain in the right clavicular area recurred and lasted for almost one month. A repeated X-ray was showed ”Non-union of the right clavicular fracture”. The patient underwent a ”redo” open reduction (ORIF) on June 2, 2009. During the operation, the patient sustained an accidental right subclavian artery injury resulting in active bleeding and pseudo-aneurysm formation there of; he was transferred to Chung Shan Medical University Hospital, and after CT angiography, he underwent endovascular repair of his right subclavian artery perforation.Results: The endovascular prosthesis (Fluency Plus Vascular Stent Graft 10 60 mm, Bard®) was successfully deployed at the site of the pseudoaneurysm via ipsilateral femoral artery access. No signs of endograft occlusion, migration, deformation, or fracrture have been observed during the follow-up period of eleven months.Conclusion: Endovascular repair of the subclavian artery injury may be an acceptable alternative to other more invasive modes of therapy. A sufficiently long follow-up, however, is needed to determine if the design of this endograft will resist compression in this vascular location.
延伸閱讀
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