在类风湿性关节炎患者的胸前动脉内有症状的自由浮动血栓的内血管解决方案:两个临床病例
G Mastrangelo1,2, P Di Sebastiano2, V Palazzo1
1Unit of Vascular Surgery, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy.
Vascular
|September 20, 2024
概括
类风湿性关节炎 (RA) 可以在胸前动脉中引起自由浮动血栓 (FFT),导致栓塞. 大动脉FFT的内血管修复是符合条件的患者的安全有效的治疗选择.
科学领域:
- 心血管外科心血管外科
- 类风湿病学 类风湿病学
- 血管医学 血管医学
背景情况:
- 类风湿性关节炎 (RA) 是一种自身免疫性疾病,可以影响各种器官.
- 胸前动脉中的自由浮动血栓 (FFT) 是一种罕见但严重的疾病,与栓塞事件相关.
- 风湿性关节炎和症状性大动脉FFT之间的关联尚未得到充分证实.
研究的目的:
- 呈现两例与类风湿性关节炎 (RA) 相关的胸前动脉症状自由浮动血栓 (FFT) 的临床病例.
- 讨论处理这些复杂病例的诊断和治疗方面的挑战.
- 突出主动脉FFT治疗在RA患者内血管内治疗的潜在作用.
主要方法:
- 案例1:患有风湿性关节炎的患者呈现出栓塞症状,接受抗凝治疗,随后进行大动脉门胸内血管大动脉修复 (TEVAR).
- 案例2:患有乳房疼痛和四肢缺血的RA患者,接受了烟TEVAR治疗,以排除在主动脉门中的FFT.
- 这两起案件都涉及详细成像 (CTA) 和多学科的大动脉团队管理.
主要成果:
- 在这两种情况下,内血管修复成功,没有直接的并发症.
- 干预后没有新的血栓发作.
- 在RA和FT患者中证明了复杂的内血管大动脉修复的可行性.
结论:
- 胸前大动脉评估对于患有无法解释的外周栓塞的患者至关重要.
- 症状性大动脉FFT的内血管治疗对于某些患者,包括RA患者,可能是一个有效和安全的选择.
- 需要进一步的研究,以建立最佳的治疗策略和RA患者大动脉FFT的长期结果.
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