超声引导下腔内血管成形术治疗动静脉内瘘狭窄早期疗效评估

目的探讨超声引导下腔内血管成形术在治疗血液透析动静脉内瘘(AVF)狭窄的早期疗效。方法回顾性分析接受超声引导下经皮腔内血管成形术(PTA)治疗的24例前臂AVF狭窄的透析患者的临床资料,比较术前及术后即刻狭窄处内径,对通畅率采用Kaplan-Meier生存分析。结果 24例患者均获得技术成功,成功率为100%(24/24)。无穿刺部位假性动脉瘤及皮下血肿等并发症发生,除1例术后AVF血栓形成,围术期无患者死亡。术后随访3、6、9、12个月的初级通畅率分别为87.50%(21/24)、83.33%(20/24)、79.17%(19/24)、58.33%(14/24)。结论超声引导下PTA治疗AVF狭窄性病变微创、安全,是AVF狭窄性病变的合理治疗方法,近期效果明显。

Evaluation of early efficacy of ultrasound-guided percutaneous transluminal angioplasty in treatment of arteriovenous fistula stenosis

Objective To evaluate the efficacy of ultrasound-guided percutaneous transluminal angioplasty (PTA) in the treatment of arteriovenous fistula (AVF) stenosis for hemodialysis. Methods A retrospective analysis of the clinical data of 24 dialysis patients with stenosis of forearm AVF treated with ultrasound-guided PTA was performed. Preoperative and postoperative diameters of stenosis were compared. Kaplan-Meier survival analysis was used to evaluate patency rate. Results All the operations of 24 patients achieved technical success with a success rate of 100%(24/24). No patient died during the perioperative period, no complications such as pseudoaneurysm at the puncture site and subcutaneous hematoma occurred, except for 1 case of thrombosis. The primary patency rate was 87.50%(21/24), 83.33%(20/24), 79.17%(19/24), 58.33%(14/24) at 3, 6, 9 and 12 months, respectively. Conclusion Ultrasound-guided PTA is a safe and minimally invasive treatment for AVF stenosis with a good early result.