口服避孕药继发急性锁骨下动脉血栓形成1例报告

M. Ghiasian, Sajjad Daneshyar, M. Olfat
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摘要

在没有血管病变史的女性中,锁骨下动脉血栓形成是一种罕见的肢体缺血原因。这种情况通常继发于动脉粥样硬化变化和高凝状态,通常无症状。然而,它可以表现为上肢冰冷、疼痛和无脉搏等症状。在此,我们介绍了一位40岁的女性,她入院时有三天的右侧偏瘫病史,并有不平衡和眩晕的主诉。患者有2个月服用高剂量口服避孕药(OCP)进行节育的病史。颈部磁共振血管造影术显示左锁骨下动脉近端明显闭塞,导致诊断为长期使用高剂量OCP继发的锁骨下动脉血栓形成。我们的诊断是通过彩色多普勒超声确认的。该病例表明,无论患者的主要投诉如何,都必须进行全面评估。这种评估可以实现更快、更有效的管理,从而降低相关成本。因此,即使在低风险患者中,也应随访动脉血栓形成的任何提示性体征或症状。因此,如果在诊断动脉血栓形成方面取得了证实性结果,则应立即对患者进行适当的医疗和手术干预。
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Acute Subclavian Artery Thrombosis Secondary to Oral Contraceptive Agent Consumption: A Case Report
Subclavian artery thrombosis is an uncommon cause of limb ischemia in females without a history of vasculopathy. This condition usually occurs secondary to atherosclerotic changes and hypercoagulable states, which are generally asymptomatic. However, it can manifest with such symptoms as coldness, pain, and pulselessness in the upper extremity. Herein, we presented a 40-year-old female admitted to our hospital with three days history of right-side hemiparesis and complaints of imbalance and vertigo. The patient had a history of 2-month consumption of high-dose oral contraceptive (OCP) agents for birth control purposes. Cervical magnetic resonance angiography showed a significant occlusion in the proximal part of the left subclavian artery, leading to the diagnosis of subclavian artery thrombosis secondary to the use of long-term high-dose OCP. Our diagnosis was confirmed with the Doppler color sonography. This case demonstrated the importance of a full assessment regardless of the patient’s chief complaints. This kind of assessment allows for a faster and more effective management, thereby reducing the associated costs. Therefore, any suggestive signs or symptoms of arterial thrombosis should be followed up even in low-risk patients. Accordingly, in case the achievement of confirmatory findings regarding the diagnosis of arterial thrombosis, the patient should be immediately subjected to proper medical and surgical interventions.
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