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多重悖论性栓塞是由穿过圆孔的中央静脉导管血栓引起的:一个案例报告
Jian-Duan Li1, Nian Xu1, Qiang Zhao1
1Department of Cardiology, Guangzhou Red Cross Hospital of Jinan University, Guangzhou 510235, Guangdong Province, China.
World journal of clinical cases
|February 7, 2024
概括
中枢静脉导管 (CVC) 血栓可以导致异常栓塞 (PDE) 在冠状动脉和下肢动脉,在患者的专利圆孔 (PFO). 这一案例凸显了考虑CVC作为多重栓塞的来源的重要性.
科学领域:
- 心脏病学 心脏病学
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
背景情况:
- 悖论性栓塞 (PDE) 是一种罕见的事件,静脉血栓进入动脉循环,通常通过右向左的分流.
- 中枢静脉导管 (CVC) 与静脉血栓形成的风险增加有关.
- 圆孔 (PFO) 是一种常见的心脏异常,可以促进PDE.
研究的目的:
- 报告第一个记录的冠状动脉和下肢动脉栓塞同时发生的病例,这是PFO患者中CVC相关的血栓的次要病例.
- 强调CVC相关的血栓在PFO存在时可能导致广泛的动脉栓塞.
主要方法:
- 一份病例报告详细介绍了一名患有急性胸痛和下肢疲劳的患者.
- 诊断工作包括多普勒超声波以确定静脉血栓和心声回声来确认PFO与可诱导的分流.
- 管理涉及抗凝治疗和CVC去除,没有干预PFO关闭.
主要成果:
- 在右侧内静脉中,在CVC的尖端确定了一个大血栓.
- 心声扫描证实在瓦萨尔瓦演习期间,PFO与右向左转位.
- 患者通过抗凝药和CVC去除成功管理,在随访期间没有血栓复发.
结论:
- 中枢静脉导管相关的血栓形成是一个显著的危险因素,矛盾的栓塞在患者的专利卵巢孔.
- 这一案例凸显了一个单一的CVC血栓在多个动脉区域 (冠状动脉和下肢) 引起同时栓塞的可能性.
- 通过抗凝药和导管切除进行保守的治疗,可以有效地预防PFO患者的PDE复发.
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