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首页> 外文期刊>European Heart Journal - Case Reports >Short- and mid-term effects of covered stent implantation on extremity findings and heart failure in Parkes Weber syndrome: a case report
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Short- and mid-term effects of covered stent implantation on extremity findings and heart failure in Parkes Weber syndrome: a case report

机译：覆盖支架植入对帕克斯韦​​伯综合征的覆盖支架植入对极端发现和心力衰竭的短期和中期影响：案例报告

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Background Parkes Weber syndrome (PWS) is a congenital disease characterized by vascular malformations, such as arteriovenous fistulas (AVFs). It frequently presents with overgrowth of a lower limb and high-output heart failure. The main treatment is to close vascular malformations. Surgical excision or endovascular coil insertion was performed in a few patients with AVFs. However, vascular covered stent implantation has not been used for treating PWS. Case summary A 15-year-old male patient with PWS presented to our hospital because of dyspnoea and massive left upper limb swelling. After initial examination and left upper limb angiography, his symptoms and findings were attributed to the presence of high-flow large AVFs despite the presence of many coils previously inserted. We decided to implant a covered stent along the AVFs between the subclavian and axillary arteries. After stent implantation, the patient’s complaints and findings improved during the early term but they relapsed at the 6th month after percutaneous intervention. Discussion Here, we report for the first time the use of covered stent implantation and its short and 6?months results in a patient with PWS. Although initial improvements were noted, the clinical outcome at 6?months after stent implantation was poor. This was probably associated with the presence of widespread subtle AVFs or collateral connections among the existing AVFs. Based on our result, we propose that closure of large AVFs is not useful and more definitive interventions, such as limb amputation may be required earlier.
机译：背景帕韦伯综合征（PWS）是一种先天性疾病，其特征在于血管畸形，如动静脉瘘（AVFS）。它经常具有较低的肢体和高输出心力衰竭的过度生长。主要治疗是密切的血管畸形。在少数AVF患者中进行手术切除或血管内卷材插入。然而，血管覆盖的支架植入尚未用于治疗PWS。案例摘要一名15岁男性患者由于呼吸困难而呈现给我们医院的PWS和巨大的左上肢肿胀。在初始检查和左上肢血管造影后，尽管存在先前插入许多线圈，但他的症状和发现归因于高流量大的AVF。我们决定植入亚克拉夫和腋动脉之间的AVF的覆盖支架。在支架植入后，患者的投诉和调查结果在早期改善，但它们在经皮干预后的第6个月复发。在此讨论，我们首次报告使用覆盖的支架植入及其短期和6个月，为PWS的患者导致患者产生。虽然已经注意到初步改进，但在支架植入较差后6个月的临床结果差。这可能与现有AVFS之间的广泛微妙AVFS或侧支连接的存在有关。根据我们的结果，我们提出了大型AVFS的关闭不是有用，更明确的干预措施，例如肢体截肢。

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