NEJM:TAVR后腋动脉闭塞-病例报道

2020-01-09 xing.T MedSci原创

血栓切除术后,患者右臂疼痛和无力症状缓解。TAVR后开始使用阿司匹林和氯吡格雷双重抗血小板治疗被停药,并开始使用口服抗凝剂治疗。

患者为一名84岁的男性,在接受经导管主动脉瓣置换术(TAVR)治疗有症状的主动脉瓣狭窄7天后,右臂突然出现剧烈疼痛和无力。

体格检查发现右前臂苍白,右侧桡动脉和肱动脉搏动不明显,右臂力量减弱。三维计算机断层血管造影显示右腋动脉闭塞(如图A箭头所示),二维血管造影显示非冠状动脉和左冠状动脉小叶增厚(如图B箭头所示)。



患者进行了手术血栓切除术,并去除了新鲜的血栓。血栓切除术后经食管超声心动图检查发现非冠状主动脉瓣增厚,但无心内血栓。跨瓣膜压梯度测量为15mmHg,比TAVR后测得的8 mmHg有所增加。

血栓切除术后,患者右臂疼痛和无力症状缓解。TAVR后开始使用阿司匹林和氯吡格雷双重抗血小板治疗被停药,并开始使用口服抗凝剂治疗。
 
原始出处:

Alexander Kille, et al.Axillary Artery Occlusion after TAVR.N Engl J Med 2019;https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg

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    2021-03-23 病毒猎手
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  4. [GetPortalCommentsPageByObjectIdResponse(id=950494, encodeId=319f950494aa, content=<a href='/topic/show?id=32461e1634a' target=_blank style='color:#2F92EE;'>#TAVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17163, encryptionId=32461e1634a, topicName=TAVR)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Mar 23 22:57:46 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086387, encodeId=d86e208638ebb, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Thu Apr 30 02:01:00 CST 2020, time=2020-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2022212, encodeId=da4f202221266, content=<a href='/topic/show?id=cbec3334967' target=_blank style='color:#2F92EE;'>#动脉闭塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33349, encryptionId=cbec3334967, topicName=动脉闭塞)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/017ED6AFEB45F49165298113DDC0656A/100, createdBy=84182500174, createdName=ms7019579240139182, createdTime=Thu Sep 10 14:01:00 CST 2020, time=2020-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2065914, encodeId=0b1920659148e, content=<a href='/topic/show?id=c3058531565' target=_blank style='color:#2F92EE;'>#腋动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85315, encryptionId=c3058531565, topicName=腋动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3333505, createdName=gujh, createdTime=Fri May 15 09:01:00 CST 2020, time=2020-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035081, encodeId=b2e810350811c, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jan 09 11:01:00 CST 2020, time=2020-01-09, status=1, ipAttribution=)]
    2020-05-15 gujh
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    2020-01-09 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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