PINCH-OFF SYNDROME - A COMPLICATION OF IMPLANTABLE SUBCLAVIAN VENOUS ACCESS DEVICES
PINCH-OFF SYNDROME - A COMPLICATION OF IMPLANTABLE SUBCLAVIAN VENOUS ACCESS DEVICES
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DOI：
10.1148/radiology.177.2.2217768
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发表时间：
1990-11-01
期刊：
影响因子：
19.7
通讯作者：
ANDRIS, DA
中科院分区：
文献类型：
--
作者：
HINKE, DH;ZANDTSTASTNY, DA;ANDRIS, DA
通过锁骨下静脉置入的植入式中心静脉通路装置可能会因血栓形成、撞击静脉壁或锁骨和第一肋骨之间的压迫而阻塞。后者被称为夹断综合征（POS）。研究了11例POS患者，其中1例导管断裂，1例导管断裂，1例导管碎裂。并与22例正常对照组和100例常规门诊患者进行比较。对每根导管进行分级：0 =正常，1 =病程突然变化，无管腔狭窄，2 =管腔狭窄，3 =导管完全断裂。POS存在于大多数（8/11）的情况下，在3周内放置后。1级导管在对照组中很常见（33%），但2级和3级导管不常见（1%）。在2例或2例长期（> 3周）夹捏（2级导管）中观察到导管断裂或碎裂。得出以下结论：2级代表显著的导管压迫和严重并发症的可能性。由于1级在对照受试者中的患病率较高，因此其临床意义不确定。
Implantable central venous access devices placed via the subclavian vein may become obstructed by thrombosis, impingement against a vein wall, or compression between the clavicle and first rib. The latter has been termed pinch-off syndrome (POS). Eleven patients with POS were studied, including one whose catheter had fractured and one whose catheter had fractured and one whose catheter had fragmented. They were compared with 22 matched control patients and 100 consecutive routine clinic patients. Each catheter was graded: 0 = normal, 1 = abrupt change in course with no luminal narrowing, 2 = luminal narrowing, and 3 = complete catheter fracture. POS was present in most (eight of 11) cases within 3 weeks after placement. A grade 1 catheter was common (33%) among control subjects, but grades 2 and 3 were uncommon (1%). Catheter fracture or fragmentation was seen in two or cases with long-term (> 3 weeks) pinching (grade 2 catheter). The following conclusions were reached: Grade 2 represents significant catheter compression and the potential for serious complications. Grade 1 is of uncertain clinical significance, due to its high prevalence in control subjects.