自体动静脉内瘘失功的腔内治疗
摘要
目的探讨腔内治疗自体动静脉内瘘(AVF)失功的临床疗效。方法回顾性分析2015年1月至2016年6月该科确诊为自体AVF失功行经皮血管腔内成形术(PTA)治疗的27例病例资料。统计分析自体AVF狭窄闭塞段的部位、数目,术后即时,1、3、6、12个月并发症及内瘘通畅率。结果共收集27例患者,共35处狭窄闭塞,吻合口附近20例,静脉穿刺段12例,中心静脉段3例。所有病例均使用球囊扩张[普通球囊和(或)高压球囊],3例中心静脉狭窄采用球囊扩张后置入支架。术后即时开通27例,成功率为100.0%,其中1例术中开通后突发心力衰竭,1例术后穿刺点渗血,并发症发生率为7.4%,所有病例均无血管破裂、肺栓塞等并发症出现。术后1个月通畅率为100.0%(27/27),3个月通畅率为96.3%(26/27),6个月通畅率为81.5%(22/27),12个月通畅率为66.7%(18/27)。结论腔内治疗自体AVF失功即时开通率及短中期通畅率高,术后并发症少,创伤小,可重复进行,可作为AVF失功治疗的优先选择方法之一。
引文
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[8]赵文静,褚以德,王宁宁,等.血清成纤维细胞生长因子23在维持性血液透析患者血管钙化中作用的研究进展[J].山东医药,2016,56(37):104-106.
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[12] NAEL K,KEE ST,SOLOMON H,et al. Endovascular management of central thoracic Veno-Occlusive diseases in hemodialysis patients:a single institutional experience in 69 consecutive patients[J]. J Vasc Interv Radiol,2009,20(1):46-51.
[13]张家庆,刘萍,王业梅.支架植入与球囊扩张治疗自体动静脉内瘘狭窄疗效比较[J].安徽医学,2017,38(6):720-722.
[14] PORTUGALLER RH,KALMAR PI,DEUTSCHMANN H. The eternal tale of dialysis access vessels and restenosis:are drug-eluting balloons the solution?[J]. J Vasc Access,2014,15(6):439-447.
[15]?ILDA?MB,K?SEO?LU?F,AKDAM H,et al. The primary patency of drug-eluting balloon versus conventional balloon angioplasty in hemodialysis patients with arteriovenous fistula stenoses[J]. Jpn J Radiol,2016,34(10):700-704.
[16] AYEZ N,FIOOLE B,ARTS RA,et al. Secondary interventions in patients with autologous arteriovenous fistulas strongly improve patency rates[J]. J Vasc Surg,2011,54(4):1095-1099.
[2]CAMPOS RP,DO NASCIMENTO MM,CHULA DC,et al.Stenosis in hemodialysis arteriovenous fistula:evaluation and treatment[J].Hemodial Int,2006,10(2):152-161.
[3]AMANO I,OHIRA S,GOTO Y,et al.In preparation for a treatment guideline for suitable vascular access repair in Japan[J].Ther Apher Dial,2006,10(4):364-371.
[4]VASANTHAMOHAN L,GOPEE-RAMANAN P,ATHREYA S.The management of cephalic arch stenosis in arteriovenous fistulas for hemodialysis:a systematic review[J].Cardiovasc Intervent Radiol,2015,38(5):1179-1185.
[5]ROY-CHAUDHURY P,SUKHATME VP,CHEUNG AK.Hemodialysis vascular access dysfunction:a cellular and molecular viewpoint[J].J Am Soc Nephrol,2006,17(4):1112-1127.
[6]钟海英,王意清,吴凤金,等.自体动静脉内瘘失功的相关因素[J].广东医学,2010,31(24):3249-3251.
[7]AHMAD I.Salvage of arteriovenous fistula by angioplasty of collateral veins establishing a new channel[J].J Vasc Access,2007,8(2):123-125.
[8]赵文静,褚以德,王宁宁,等.血清成纤维细胞生长因子23在维持性血液透析患者血管钙化中作用的研究进展[J].山东医药,2016,56(37):104-106.
[9] TREROTOLA SO,KWAK A,CLARK TW,et al. Prospective study of balloon inflation pressures and other technical aspects of hemodialysis access angioplasty[J]. J Vasc Interv Radiol,2005,16(12):1613-1618.
[10] AFTAB SA,TAY KH,IRANI FG,et al. Randomized clinical trial of cutting balloon angioplasty versus high-pressure balloon angioplasty in hemodialysis arteriovenous fistula stenoses resistant to conventional balloon angioplasty[J]. J Vasc Interv Radiol,2014,25(2):190-198.
[11] MACRAE JM,DIPCHAND C,OLIVER M,et al. Arteriovenous Access Failure,Stenosis,and Thrombosis[J]. Can J Kidney Health Dis,2016,3:2054358116669126.
[12] NAEL K,KEE ST,SOLOMON H,et al. Endovascular management of central thoracic Veno-Occlusive diseases in hemodialysis patients:a single institutional experience in 69 consecutive patients[J]. J Vasc Interv Radiol,2009,20(1):46-51.
[13]张家庆,刘萍,王业梅.支架植入与球囊扩张治疗自体动静脉内瘘狭窄疗效比较[J].安徽医学,2017,38(6):720-722.
[14] PORTUGALLER RH,KALMAR PI,DEUTSCHMANN H. The eternal tale of dialysis access vessels and restenosis:are drug-eluting balloons the solution?[J]. J Vasc Access,2014,15(6):439-447.
[15]?ILDA?MB,K?SEO?LU?F,AKDAM H,et al. The primary patency of drug-eluting balloon versus conventional balloon angioplasty in hemodialysis patients with arteriovenous fistula stenoses[J]. Jpn J Radiol,2016,34(10):700-704.
[16] AYEZ N,FIOOLE B,ARTS RA,et al. Secondary interventions in patients with autologous arteriovenous fistulas strongly improve patency rates[J]. J Vasc Surg,2011,54(4):1095-1099.