刘帅,谢雄伟,蔡珺

• 1:惠州市中心人民医院心内科
• 2:惠州市中心人民医院特需病房

摘要(Abstract)：

锁骨下静脉穿刺是心脏临时起搏器植入的常用入路，但因毗邻锁骨下动脉、颈总动脉等重要血管，存在误穿动脉的罕见严重风险，覆膜支架介入为该类医源性血管损伤提供了微创治疗方案。本病例报道1例68岁扩张型心肌病女性患者，因住院期间反复室性心动过速，经左锁骨下静脉路径植入临时起搏器；术后影像学检查提示起搏电极误入左心室，CT血管造影进一步证实穿刺鞘管误入左颈总动脉。为避免直接拔管所致的大出血等并发症，采用血管介入方式置入覆膜支架封堵动脉穿刺口，顺利拔除鞘管。本病例提示，锁骨下静脉穿刺可发生误穿颈总动脉的罕见并发症，覆膜支架封堵术是安全有效的处理手段，术前影像评估与术中精准操作对预防并发症至关重要。

关键词(KeyWords)： 锁骨下静脉;穿刺;动脉误穿;覆膜支架;并发症;起搏器植入

Abstract:

Keywords:

基金项目(Foundation): 广东省基础与应用基础研究基金区域联合基金项目（2025A1515140222）

作者(Author): 刘帅,谢雄伟,蔡珺

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