血管成形术治疗透析用动静脉内瘘狭窄

目的 探讨血管成形术在治疗血液透析动静脉内瘘狭窄中的作用. 方法 选择2006年7月至2013年2月中国中医科学院西苑医院37例血液透析动静脉内瘘狭窄闭塞的患者进行经皮腔内血管成形术治疗经肱动脉顺行穿刺,行前臂动脉造影检查及动静脉内瘘狭窄血管段球囊扩张血管成形术.结果 37例患者中34例成功进行了血管成形治疗,术后造影显示血管狭窄消失,术后透析血流量大于250ml/min,满足血液透析需求,技术成功率及临床成功率均为91.9％,术后平均随访12.3个月,3、6和12个月初始通畅率分别为94.2％、88.5％和78.3％,术中未出现严重并发症.结论 血管成形术是治疗血液透析动静脉内瘘狭窄的有效方法,甚至可作为治疗血液透析动静脉内瘘狭窄的首选方法.

Percutaneous transluminal angioplasty for stenosis in hemodialysis arteriovenous fistula

Objective To evaluate the effect of percutaneous transluminal angioplasty（PTA） in treatment of the stenosis in hemodialysis arteriovenous fistula （AVF）.Methods 37 patiens From July,2006 to February,2013 in our hospital,who with stenosis in hemodialysis AVF,received PTA for stenosis in hemodialysis AVF.Anterograde puncture brachial artery,angiography for forearm and finding the stenosis in AVF,then try to pass through the stenosis with guidewire and balloon angioplasty the lesions of stenosis.Finally angiography again to evaluate the effect of treatment.Results In all 37 patients,34 patients underwent treatment of PTA successfully,the stenosis in AVF disappeared through angiography.The AVF blood flow was larger than 250 ml/min during hemodialysis,and enough for the requirement of hemodialysis.Technical and clinical success rates were 91.9％ . Average followup 12.3 month,3-mo、6-mo and 12-mo primary patency rate is 94.2％、88.5％ and 78.3％.no severe complications occurred.Conclusions Angioplasty is an effective method for the stenosis ofAVF,and even can be used as first choice for AVF stenosis.