误穿右锁骨下动脉介入封堵1例  

Closure of puncture of the right subclavian artery:a case report

作　　者：双东思 王江友 余春俊 SHUANG Dong-si;WANG Jiang-you;YU Chun-jun(Department of Cardiovascular Internal and Surgical Medicine,Wuhan Yaxin General Hospital,Wuhan 430056,China)

机构地区：[1]武汉亚心总医院心血管内外科,湖北武汉430056

出　　处：《中国介入心脏病学杂志》2025年第1期51-53,共3页Chinese Journal of Interventional Cardiology

基　　金：武汉市科委课题项目(WX14C79);武汉市卫生健康科研基金资助项目(WX20Q31)。

摘　　要：本文报道了1例59岁女性患者因突发失语和左侧肢体乏力就诊,急诊行脑血管造影术+颅内动脉取栓术后,在右锁骨下静脉穿刺过程中误穿右锁骨下动脉。通过Mimics软件和3dsMAX进行三维重建和术前模拟,确定皮下隧道长度及Angioseal封堵器各部件的适用性。术前模拟显示,隧道长度74.6 mm,满足皮下隧道<塞压管<Angioseal导管鞘的条件,遂行Angioseal封堵术。术后造影显示封堵效果满意,患者未出现并发症。本文讨论了误穿锁骨下动脉的处理难点及Angioseal封堵器的应用条件,指出术前三维重建和模拟对于确保手术成功的重要性。对于隧道长度不超过88 mm的误穿锁骨下动脉,Angioseal封堵器是一种安全有效的方法。This paper reports a case of a 59-year-old female patient who presented with sudden aphasia and left-sided weakness.After emergency cerebral angiography and intracranial artery thrombectomy,the left subclavian artery was accidentally punctured during left subclavian vein catheterization.Three-dimensional reconstruction and preoperative simulation using Mimics software and 3dsMAX were performed to determine the subcutaneous tunnel length and the applicability of the Angioseal closure device.Preoperative simulation showed a tunnel length of 74.6 mm,satisfying the condition of subcutaneous tunnel<compression tube<Angioseal introducer.Angioseal closure was then performed.Postoperative angiography showed satisfactory occlusion,and the patient had no complications.This paper discusses the challenges in managing accidental subclavian artery punctures and the application conditions of the Angioseal closure device,emphasizing the importance of preoperative three-dimensional reconstruction and simulation for ensuring surgical success.For accidental subclavian artery punctures with tunnel lengths not exceeding 88 mm,the Angioseal closure device is a safe and eff ective method.

关 键 词：锁骨下动脉 Angioseal封堵器 心血管建模 术前模拟 

分 类 号：R54[医药卫生—心血管疾病]