Baidu
map

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

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [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=138, 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=108, 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=94, 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=65, 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=93, 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=)]
  2. [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=138, 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=108, 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=94, 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=65, 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=93, 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=)]
  3. [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=138, 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=108, 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=94, 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=65, 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=93, 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=)]
  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=138, 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=108, 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=94, 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=65, 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=93, 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
  5. [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=138, 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=108, 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=94, 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=65, 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=93, 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=)]
    2020-01-09 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

    0

相关资讯

JAHA:在TAVR和非TAVR中心接受外科主动脉瓣置换术的住院结局差异

与非TAVR中心相比,在TAVR中心接受SAVR的患者生存率更高并且出院状态更好。

JACC:退伍军人接受TAVR的结局

在VA中心接受TAVR治疗的退伍军人主要是老年男性,合并症严重。30天的临床结局、再入院率及1年死亡率优于VA以外的基准结局数据。

JACC:二叶式主动脉瓣狭窄经导管与外科主动脉瓣置换的时间趋势和结局

这项全国性分析表明,二叶式AS患者TAVR与SAVR的院内死亡率相似。

Circulation:经导管或外科主动脉瓣置换术后的人工瓣膜心内膜炎

人工瓣膜心内膜炎(PVE)是经导管和外科主动脉瓣置换术(TAVR, SAVR)后导致瓣膜衰竭和死亡的罕见但至关重要的机制,值得在现代主动脉瓣置换术经验中进一步分析。现研究人员对PVE的发病率、危险因素、微生物特征及预后进行分析。研究人员对PARTNER 1和PARTNER 2试验以及注册的所有患者的汇集队列进行分析。所有患者均为主动脉重度狭窄,采用TAVR或SAVR治疗。共纳入8530位患者。平均

JACC:使用环上和环内瓣膜进行TAVR的假体-患者不匹配

无论瓣环面积如何,SEV的PPM发生率均低于BEV。差异主要是由BSA> 1.83m2的患者造成的。

JACC:择期经导管主动脉瓣置换术手术中止的相关因素和结局

手术中止的发生率正在下降,但是外周动脉疾病和机构TAVR手术量低仍与中止手术有关。

Baidu
map
Baidu
map
Baidu
map