医原性右鎖骨下動脈損傷に対してpull-through法を用いて血管内治療を行った1例
症例は52歳男性．呼吸苦および全身倦怠感を自覚し前医を受診した．精査の結果，尿毒症と診断され緊急透析のために右内頸静脈より12 Frのバスキュラーアクセスカテーテル（VAカテーテル）が留置された．胸部X線検査でVAカテーテルの走行異常に気付かれ，造影CT (computed tomography) 検査が施行された．VAカテーテルが右内頸静脈を貫通後に右鎖骨下動脈を穿通し，上行大動脈内まで達していたため当院へ搬送された．全身麻酔下に両側上腕動脈の間でpull-through法を用いてGORE VIABAHNを挿入し，右鎖骨下動脈損傷を治療した．術後造影CT検査で出血がないことを確認し，術後第2...
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| Published in | 日本心臓血管外科学会雑誌 Vol. 52; no. 5; p. 349 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本心臓血管外科学会
15.09.2023
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0285-1474 1883-4108 |
| DOI | 10.4326/jjcvs.52.349 |
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| Abstract | 症例は52歳男性．呼吸苦および全身倦怠感を自覚し前医を受診した．精査の結果，尿毒症と診断され緊急透析のために右内頸静脈より12 Frのバスキュラーアクセスカテーテル（VAカテーテル）が留置された．胸部X線検査でVAカテーテルの走行異常に気付かれ，造影CT (computed tomography) 検査が施行された．VAカテーテルが右内頸静脈を貫通後に右鎖骨下動脈を穿通し，上行大動脈内まで達していたため当院へ搬送された．全身麻酔下に両側上腕動脈の間でpull-through法を用いてGORE VIABAHNを挿入し，右鎖骨下動脈損傷を治療した．術後造影CT検査で出血がないことを確認し，術後第2病日に紹介元病院へ転院した．今回われわれは，医原性右鎖骨下動脈損傷に対してpull-through法を用いて血管内治療を行った1例を経験したので文献的考察を加えて報告する． |
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| AbstractList | 症例は52歳男性．呼吸苦および全身倦怠感を自覚し前医を受診した．精査の結果，尿毒症と診断され緊急透析のために右内頸静脈より12 Frのバスキュラーアクセスカテーテル（VAカテーテル）が留置された．胸部X線検査でVAカテーテルの走行異常に気付かれ，造影CT (computed tomography) 検査が施行された．VAカテーテルが右内頸静脈を貫通後に右鎖骨下動脈を穿通し，上行大動脈内まで達していたため当院へ搬送された．全身麻酔下に両側上腕動脈の間でpull-through法を用いてGORE VIABAHNを挿入し，右鎖骨下動脈損傷を治療した．術後造影CT検査で出血がないことを確認し，術後第2病日に紹介元病院へ転院した．今回われわれは，医原性右鎖骨下動脈損傷に対してpull-through法を用いて血管内治療を行った1例を経験したので文献的考察を加えて報告する． |
| Author | 馬場, 啓徳 中村, 栄作 岩﨑, あや香 |
| Author_xml | – sequence: 1 fullname: 岩﨑, あや香 organization: 県立宮崎病院心臓血管外科 – sequence: 1 fullname: 中村, 栄作 organization: 県立宮崎病院心臓血管外科 – sequence: 1 fullname: 馬場, 啓徳 organization: 県立宮崎病院心臓血管外科 |
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| References | 9) Matsunaga Y, Takahashi M, Shimizu Y et al. Central venous catheter-induced subclavian artery injury treatment with endovascular techniques: case report. JJAAM 2022; 33: 1010-5. 1) Guilbert MC, Elkouri S, Bracco D et al. Arterial trauma during central venous catheter insertion: case series, review and proposed algorithm. J Vasc Surg 2008; 48: 918-25. 8) Umeda R, Nakajima T, Iba Y et al. A case of accidental right subclavian aretry injury during central venous catheterization through the right internal juglar vein. Jpn J Cardiovasc Surg 2022; 51: 368-71. 10) Harada H, Ota K, Takido Y et al. A case report of placing covered stent for bile duct by pull through technique for iatrogenic pseudoaneurysm of common carotid artery. Neurotraumatology 2019; 42: 50-3. 3) Nihon Masui Gakkai. Anzen na chusin jomyaku kate-teru sonyu. Kanri no tame no practical guide 2017 [Internet]. Koueki Syadan Houjin Nihon Masuigakkai Anzen Iinkai;(cited 2017 Jun). Available from: https://anesth.or.jp/files/pdf/JSA_CV_practical_guide_2017.pdf (12/02/2023 7) Kuwauchi S, Zempo N, Sakashita H et al. Use of VIABAHN stent graft for subclavian artery injury due to inadvertent catheter placement. Jpn J Cardiovasc Surg 2020; 49: 86-9. 2) Ippan Syadan Houjin Nihon Iryo Anzen Chosa Kiko. Chusin jomyaku sensi gappeisyo ni kakawaru sibo no bunseki-dai-1po-iryo jiko no saihatsu bosi ni muketa teigen dai1go. 2018 [Internet]. Iryojiko・Sien Senta; (cited 2018 Mar). Available from: https:// www.medsafe.or.jp/uploads/uploads/files/publication/teigen-01.pdf, (11/02/2023 4) Shioguchi S, Irie Y, Yoshida S et al. Two cases: internal thoracic artery and subclavian artery injury induced by blunt trauma. Jpn J Vasc 2005; 14: 705-8. 5) Oshima A, Yuri M, Minami T et al. Iatrogenic vascular injury－an analysis of 24 cases－. Jpn J Vasc Surg 2001; 10: 461-7. 6) Branco BC, Boutrous ML, DuBose JJ et al. Outcome comparison between open and endovascular management of axillosubclavian arterial injuries. J Vasc Surg 2016; 63: 702-9. 11) Kawaguchi S, Yokoi Y, Shimazaki T et al. Endovascular stent grafting for thoracic aortic aneurysms. J Jpn Coll Angiol 2008; 48: 257-62. 12) Toyota T, Saito N, Minakata K et al. Successful management of guidewire kinking in a patient with subaortic septal bulging using the pull-through technique during transapical transcatheter aortic valve implantation. Circ J 2016; 80: 258-60. |
| References_xml | – reference: 4) Shioguchi S, Irie Y, Yoshida S et al. Two cases: internal thoracic artery and subclavian artery injury induced by blunt trauma. Jpn J Vasc 2005; 14: 705-8. – reference: 1) Guilbert MC, Elkouri S, Bracco D et al. Arterial trauma during central venous catheter insertion: case series, review and proposed algorithm. J Vasc Surg 2008; 48: 918-25. – reference: 5) Oshima A, Yuri M, Minami T et al. Iatrogenic vascular injury－an analysis of 24 cases－. Jpn J Vasc Surg 2001; 10: 461-7. – reference: 9) Matsunaga Y, Takahashi M, Shimizu Y et al. Central venous catheter-induced subclavian artery injury treatment with endovascular techniques: case report. JJAAM 2022; 33: 1010-5. – reference: 6) Branco BC, Boutrous ML, DuBose JJ et al. Outcome comparison between open and endovascular management of axillosubclavian arterial injuries. J Vasc Surg 2016; 63: 702-9. – reference: 10) Harada H, Ota K, Takido Y et al. A case report of placing covered stent for bile duct by pull through technique for iatrogenic pseudoaneurysm of common carotid artery. Neurotraumatology 2019; 42: 50-3. – reference: 11) Kawaguchi S, Yokoi Y, Shimazaki T et al. Endovascular stent grafting for thoracic aortic aneurysms. J Jpn Coll Angiol 2008; 48: 257-62. – reference: 7) Kuwauchi S, Zempo N, Sakashita H et al. Use of VIABAHN stent graft for subclavian artery injury due to inadvertent catheter placement. Jpn J Cardiovasc Surg 2020; 49: 86-9. – reference: 8) Umeda R, Nakajima T, Iba Y et al. A case of accidental right subclavian aretry injury during central venous catheterization through the right internal juglar vein. Jpn J Cardiovasc Surg 2022; 51: 368-71. – reference: 12) Toyota T, Saito N, Minakata K et al. Successful management of guidewire kinking in a patient with subaortic septal bulging using the pull-through technique during transapical transcatheter aortic valve implantation. Circ J 2016; 80: 258-60. – reference: 2) Ippan Syadan Houjin Nihon Iryo Anzen Chosa Kiko. Chusin jomyaku sensi gappeisyo ni kakawaru sibo no bunseki-dai-1po-iryo jiko no saihatsu bosi ni muketa teigen dai1go. 2018 [Internet]. Iryojiko・Sien Senta; (cited 2018 Mar). Available from: https:// www.medsafe.or.jp/uploads/uploads/files/publication/teigen-01.pdf, (11/02/2023） – reference: 3) Nihon Masui Gakkai. Anzen na chusin jomyaku kate-teru sonyu. Kanri no tame no practical guide 2017 [Internet]. Koueki Syadan Houjin Nihon Masuigakkai Anzen Iinkai;(cited 2017 Jun). Available from: https://anesth.or.jp/files/pdf/JSA_CV_practical_guide_2017.pdf (12/02/2023） |
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| Snippet | 症例は52歳男性．呼吸苦および全身倦怠感を自覚し前医を受診した．精査の結果，尿毒症と診断され緊急透析のために右内頸静脈より12 Frのバスキュラーアクセスカテーテル（VAカテーテル）が留置された．胸部X線検査でVAカテーテルの走行異常に気付かれ，造影CT (computed tomography)... |
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| SubjectTerms | pull-through法 医原性鎖骨下動脈損傷 血管内治療 |
| Title | 医原性右鎖骨下動脈損傷に対してpull-through法を用いて血管内治療を行った1例 |
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