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在急性支架内血栓栓塞瘤中进行机械血栓切除术
Monami Dai1, Yukihiro Imaoka2, Shinichiro Yoshikawa1
1Neuroendovascular, Saitama Medical University International Medical Center, Hidaka, Japan.
BMJ case reports
|January 23, 2024
概括
一个罕见的冠状动脉支架 (CAS) 由于血栓而不是狭窄而导致的闭塞病例,通过血栓切除术成功治疗. 这凸显了准确的成像对于分辨血管封闭的原因的重要性.
科学领域:
- 血管外科 血管外科
- 干预神经病学 干预神经病学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 动脉支架 (CAS) 是治疗内动脉狭窄 (ICA) 的常见手术.
- 静脉支架封闭后的CAS通常从急性栓塞事件演变为慢性内增生.
研究的目的:
- 报告急性动脉支架因血栓形成而封闭的病例.
- 强调在慢性CAS闭塞中,精确区分血栓和内脏增生症的重要性.
- 在这种情况下,要强调内血管血栓切除术的成功结果.
主要方法:
- 一名70岁的男性,在左ICA狭窄症中有CAS病史,出现过渡性阴影瘤.
- 磁共振成像 (MRI) 显示了急性左 ICA 阻塞.
- 进行了数字减去血管造影 (DSA),这表明在支架中的血栓.
- 紧急的内血管血栓切除术进行,以检索血栓.
主要成果:
- 据DSA证实,这是静脉栓塞,而不是静脉狭窄.
- 成功的内血管血栓切除术实现了完全的再输液.
- 动脉支架在手术后仍然没有受损.
- 患者在干预后没有经历神经缺陷.
结论:
- 喉动脉支架的急性堵塞可能是由血栓引起的,即使是在植入后数年.
- 在指导治疗决策时,准确地区分血栓和内增生症至关重要.
- 内血管血栓切除术是急性静脉动脉血栓形成的有效治疗方法.
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