在患有大中线异常动脉的患者中进行皮革扩张性气管切除术
Balaji Vaithialingam1,2, Abinash Dutta3, Swaroop Gopal3
1Division of Neuroanaesthesiology and Neurocritical Care, International Institute of Neurosciences, Aster Whitefield Hospital, Bengaluru, Karnataka, India. balamedicine04@gmail.com.
概括
穿皮扩展性气管切除术 (PDT) 通常在中线异常动脉的情况下是禁忌的. 然而,本案例报告详细介绍了使用超声波和修改技术在患有大异常动脉的患者中成功的PDT.
科学领域:
- 血管外科 血管外科
- 干预性肺病学 干预性肺病学
- 麻醉学 麻醉学
背景情况:
- 中线异常动脉被认为是穿皮扩展性气管切除术 (PDT) 的绝对禁忌.
- 在患有复杂血管解剖的重症患者中,管理呼吸道存在重大挑战.
研究的目的:
- 描述技术修改,使得在患有大中线异常动脉的患者中成功进行PDT.
- 为突出超声波在识别和导航异常血管在气管切除手术过程中的实用性.
主要方法:
- 一名72岁的女性患者患有后脑血瘤,需要长时间的机械通风.
- 在手术前的超声波检查显示,从气管中偏离的大型中线异常动脉.
- 修改后的PDT涉及到一个supraglottic气道,更高的气管入口点 (第一和第二个环),左侧前侧方法,和实时光纤支气管透视镜.
主要成果:
- 通过皮肤扩展性气管支架成功地使用Ciaglia技术进行了技术修改.
- 异常动脉在手术过程中被识别并成功避免了.
结论:
- 这份案例报告表明,经过仔细的规划,超声波和技术修改,即使存在大中线异常动脉,PDT也可能是可行的.
- 尽管有这种事的成功,外科气管切除仍然是中线异常动脉患者的推程序.
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