Tortuosity of the brachiocephalic artery complicated with arterial injury after tracheotomy: a case report
Tortuosity of the brachiocephalic artery complicated with arterial injury after tracheotomy: a case report
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DOI：
10.22514/sv151.042019.12
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发表时间：
2019-01-01
期刊：
影响因子：
1.1
通讯作者：
Oda, Jun
中科院分区：
文献类型：
--
作者：
Azuma, Kazunari;Suzuki, Shouji;Oda, Jun
气管切开术是一种甚至对重症监护患者进行的气道手术。气管切开术的手术并发症是致命的。在这项研究中，头臂动脉迂曲并发动脉损伤的病人在气管切开术后观察。我们医疗中心收治了一位95岁的昏迷妇女。患者需要气道管理，并进行了气管插管。昏迷的原因是右侧大脑中动脉的广泛脑梗死。预计昏迷时间会延长，7天后进行了气管切开术。在手术前，通过颈部计算机断层扫描证实头臂动脉迂曲。30天后，患者通过气管造口术流血的。为了阻止右颈总动脉出血，进行了血管修复手术。术后无再出血。37天后，患者死于原发病恶化。虽然气管切开术是一种常见的手术，但应注意血管的异常，包括头臂动脉的迂曲。
Tracheotomy is an operation of the airway performed even on critical care patients. Surgical complications of tracheotomies are fatal. In this study, tortuosity of the brachiocephalic artery complicated with arterial injury was observed in a patient after tracheotomy. A 95-year-old woman in coma was admitted to our medical center. The patient needed airway management, and tracheal intubation was performed. The cause of the coma was extensive cerebral infarction of the right middle cerebral artery. It was expected that the coma would be prolonged, and a tracheotomy was performed after 7 days. Tortuosity of the brachiocephalic artery was confirmed with cervical computed tomography before surgery. The patient bled through the tracheostomy after 30 days. To arrest bleeding from the right common carotid artery, a vascular repair surgery was performed. There was no recurrent bleeding after surgery. After 37 days, the patient died of deteriorating primary disease. Although tracheotomy is a common operation, attention should be paid to abnormalities of blood vessels including tortuosity of the brachiocephalic artery.