Subclavian artery (SCA) injuries associated with central venous catheter (CVC) insertion are uncommon yet lethal complications that typically require surgical treatment. This case report presents the case of a 94...Subclavian artery (SCA) injuries associated with central venous catheter (CVC) insertion are uncommon yet lethal complications that typically require surgical treatment. This case report presents the case of a 94-year-old man with an iatrogenic right SCA injury resulting from a misplaced CVC. Computed tomography revealed the catheter piercing the right internal jugular vein to enter the right SCA and then reaching the aortic arch. Emergent endovascular treatment was performed, and a 13-mm × 50-mm self-expanding Viabahn stent graft (W.L. Gore & Associates, Flagstaff, AZ, USA) was placed via the right brachial artery. The misplaced catheter was successfully removed under simultaneous postdeployment balloon dilatation. This case highlights the utility of the Viabahn stent graft for iatrogenic right SCA injury caused by a misplaced CVC and presents some insights and tips for a safer procedure.展开更多
A left-sided lesion of a coronary cameral fistula (CCF) is extremely rare. Surgical closure of the fistula is indicated when symptoms emerge or as a preventive strategy, while surgical approaches depend on the individ...A left-sided lesion of a coronary cameral fistula (CCF) is extremely rare. Surgical closure of the fistula is indicated when symptoms emerge or as a preventive strategy, while surgical approaches depend on the individual anatomical structures. In particular, a CCF forming a “fistula lake” with multiple inflow vessels is so unique that few studies have focused on the technique to close it. We report the successful management of a CCF originating from multiple coronary arteries and draining into the left ventricle via a “fistula lake” by ligation and clipping of associated communication tracts. On the postoperative coronary computed tomography angiography, the fistula lake and the small vessels entering it had all disappeared.展开更多
文摘Subclavian artery (SCA) injuries associated with central venous catheter (CVC) insertion are uncommon yet lethal complications that typically require surgical treatment. This case report presents the case of a 94-year-old man with an iatrogenic right SCA injury resulting from a misplaced CVC. Computed tomography revealed the catheter piercing the right internal jugular vein to enter the right SCA and then reaching the aortic arch. Emergent endovascular treatment was performed, and a 13-mm × 50-mm self-expanding Viabahn stent graft (W.L. Gore & Associates, Flagstaff, AZ, USA) was placed via the right brachial artery. The misplaced catheter was successfully removed under simultaneous postdeployment balloon dilatation. This case highlights the utility of the Viabahn stent graft for iatrogenic right SCA injury caused by a misplaced CVC and presents some insights and tips for a safer procedure.
文摘A left-sided lesion of a coronary cameral fistula (CCF) is extremely rare. Surgical closure of the fistula is indicated when symptoms emerge or as a preventive strategy, while surgical approaches depend on the individual anatomical structures. In particular, a CCF forming a “fistula lake” with multiple inflow vessels is so unique that few studies have focused on the technique to close it. We report the successful management of a CCF originating from multiple coronary arteries and draining into the left ventricle via a “fistula lake” by ligation and clipping of associated communication tracts. On the postoperative coronary computed tomography angiography, the fistula lake and the small vessels entering it had all disappeared.
