Acupuncture-Induced Popliteal Arteriovenous Fistula Successfully Treated with Percutaneous Endovascular Intervention

經皮血管內介入術成功治療因針灸而引起的動靜脈瘻管

郭炫孚(Hsuan-Fu Kuo) ； 石明誠(Min-Chen Paul Shih) ； 高偉斌(Wei-Pin Kao) ； 蘇河名(Ho-Ming Su) ； 林宗憲(Tsung-Hsien Lin) ； 溫文才(Wen-Chol Voon) ； 賴文德(Wen-Ter Lai) ； 許勝雄(Sheng-Hsiung Sheu)

《The Kaohsiung Journal of Medical Sciences》 26卷3期 (2010/03) Pp. 158-162

摘要

一位39歲的女性因為右膝膕窩酸痛以及感覺異常至門診求診，經觸診後發現有震顫情形。病患否認在患處有任何外傷史，但曾經在幾年前接受過針灸治療。血管超音波以及核磁共振影像懷疑該處產生動靜脈瘻管。血管攝影更進一步確認該瘻管連接右內側膝動脈與膕靜脈。我們利用了經動脈線圈置入術以及組織膠的施打成功地關閉該動靜脈瘻管。根據我們的回顧，因為針灸治療而引起的動靜脈瘻管尚未在醫學文獻中報告過。我們同時也顯示了經皮血管內介入術對於治療動靜脈瘻管的優點。對於無法用線圈完全關閉的瘻管，額外施打組織膠可以進一步將其完全關閉。我們建議臨床醫師應該對於接受針灸治療後的血管併發症以及其處理方式有所認識。

關鍵字

針灸 ； 動靜脈瘻管 ； 血管內介入術

並列摘要

A39-year-old female visited our cardiovascular outpatient department with paresthesia and soreness around the right popliteal fossa, where thrill was palpable. There was no history of trauma, apart from her having undergone acupuncture several years previously. An arteriovenous fistula (AVF) was diagnosed by vascular ultrasonography and magnetic resonance imaging. Angiography confirmed the presence of an AVF fed by the medial geniculate artery. Transarterial embolization was performed to close the AVF using coils and tissue adhesive. To the best of our knowledge, acupuncture-induced AVF has not been previously reported. We present a case demonstrating the merits of percutaneous endovascular intervention for treating this rare complication. The additional administration of a tissue adhesive can achieve complete closure of the AVF in the event of an unsatisfactory result following coil embolization. Doctors should be aware of the potential vascular complications of acupuncture, and of the management options.

並列關鍵字

acupuncture ； arteriovenous fistula ； endovascular intervention