胸部内血管动脉瘤修复后的
Saroj Kumar Sahoo1, Rudra Pratap Mahapatra2, Ramachandra Barik1
1Department of Cardiology, All India Institute of Medical Science, Bhubaneswar, Odisha, India.
JACC. Case reports
|September 26, 2025
概括
及时诊断和脑脊液 (CSF) 排水对于经过胸内血管大动脉修复 (TEVAR) 后的脊髓缺血的管理至关重要. 早期干预可以导致显著的神经恢复,即使是完全的运动缺陷.
科学领域:
- 心血管外科心血管外科
- 神经学 神经学
- 血管外科 血管外科
背景情况:
- 脊髓缺血是胸内血管大动脉修复 (TEVAR) 的严重并发症.
- 神经系统的恢复取决于及时的诊断和干预.
研究的目的:
- 为突出早期识别和干预TEVAR后脊髓缺血的重要性.
- 提出一个案例,证明及时脑脊液 (CSF) 排水的好处.
主要方法:
- 一名患者接受了TEVAR治疗下降胸前大动脉动脉瘤.
- 在TEVAR治疗后,患者出现了完全的,并失去肠/膀控制.
- 磁共振成像证实了前脊髓动脉区域中风.
- 在24小时内启动治疗性CSF排水.
主要成果:
- 在CSF排水后,患者经历了逐渐的神经改善.
- 在3个月的随访后,部分运动功能和控制能力得到恢复.
- 这一案例表明,即使在最初的完全缺陷下,也可能出现显著的神经恢复.
结论:
- 在TEVAR后,早期识别和干预对于脊髓缺血至关重要.
- 及时的CSF排水可以显著改善神经系统的结果.
- 警的术后监测对于预防永久性缺陷至关重要.
相关概念视频
Peripheral Artery Disease V: Postoperative Nursing Management
378
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
378
Aneurysm IV: Nursing Management
380
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
380
Aneurysm III: Interprofessional Care
255
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
255
Peripheral Artery Disease III: Interprofessional Care
245
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
245
Pulmonary Embolism III: Nursing Management
363
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
363
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
328
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
328


