中心静脉支架和导管之间的危险联系:一个案例报告
Matteo Maria Masseroli1,2, Daniela Torzillo1, Antonio Gidaro1,3
1Internal Medicine, L. Sacco Hospital, ASST-fbf-sacco, Milano, Italy.
The journal of vascular access
|February 6, 2026
概括
在支架内放置中央静脉导管可能会导致血栓形成和纤维细胞套,导致反复复发的高级静脉综合征. 建议使用其他途径或谨慎管理.
科学领域:
- 血管外科 血管外科
- 干预性放射学 干预性放射学
- 心脏病学 心脏病学
背景情况:
- 内血管支架是上腔静脉 (SVC) 阻塞的标准.
- 在支架内并发的中央静脉导管 (CICC) 没有指导方针.
- 恶性上静脉卡瓦综合征 (SVCS) 提出了复杂的管理挑战.
研究的目的:
- 报告在中央静脉支架 (CVS) 中放置CICC的情况.
- 为了突出血栓瘤和纤维细胞外套的共存.
- 讨论诊断和治疗方面的挑战,并建议管理策略.
主要方法:
- 一个69岁女性患有SVCS的病例报告.
- 治疗方法是进行心血管神经系统安置,然后进行关CICC插入.
- 图像 (超声波) 来评估血栓形成和纤维细胞套.
- 血栓吸收,导管切除和额外的支架安置.
主要成果:
- 在CICC插入后六天出现了复发性胀.
- 图像检查显示了广泛的血栓形成和带有"幽灵标志"的纤维细胞袖子.
- 导管切除后袖子仍然存在,这使得诊断复杂化.
结论:
- 同时放置CICC和CVS会带来血栓形成和纤维细胞套的风险.
- 这些实体可能一起发生,增加支架血栓形成和复发SVCS的可能性.
- 在等待进一步的证据之前,建议使用其他途径 (例如,腿部插入的中央导管) 和仔细的抗凝治疗.
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