摘要
目的:观察经肱动脉入路治疗自体动静脉内瘘(arteriovenous fistula,AVF)狭窄或血栓形成的有效性及安全性。方法:对2015年6月至2016年6月重庆医科大学附属第一医院血管外科经肱动脉入路对AVF狭窄或血栓形成的患者行经皮血管腔内成形术(perctuaneous transluminal angioplasty,PTA)的病例行进行回顾性分析,统计其手术成功率、并发症、随访一年内的通畅率。结果:30例患者在1年内共行介入手术38例次,其中3例在解剖肱动脉后直视下穿刺,手术成功率100%,患者术后第2 d均成功使用该内瘘透析,其中1例患者发生假性动脉瘤,发生率3.3%,随访期间第3、6、9、12月一期通畅率100.0%、90.0%、83.3%、73.3%,辅助一期通畅率100.0%、100.0%、96.7%、93.3%。结论 :肱动脉穿刺顺行入路对内瘘吻合口及其附近的狭窄或者血栓形成的AVF通过率高,术后通畅率可,严重并发症发生率低,是通路腔内治疗的重要入路之一。
Objective： To investigate the safety and efficacy of brachial artery approach in the treatment of stenosis or thrombosis of autogenous arteriovenous fistula （AVF）. Methods： A retrospective analysis was performed for the clinical data of 30 patients with AVF stenosis or thrombosis who underwent percutaneous transluminal angioplasty （PTA） with the brachial artery approach in Department of Vascular Surgery in the first affiliated hospital of chongqing medical university from June 2015 to June 2016. The success rate of surgery, complications, and patency rate within the 1-year follow-up were assessed. Results： A total of 38 interventional procedures were performed for all 30 patients, among whom three patients underwent puncture under direct vision after the dissection of the brachial artery, and the success rate of surgery was 100%. On the second day after surgery, all the patients underwent dialysis successfully via the fistula; only one patient （3.3%） suffered from pseudoaneurysm. At months 3, 6, 9, and 12 of follow-up, the primary patency rates were 100.0%, 90.0%, 83.3%, and 73.3%, respectively, and the assisted primary patency rates were 100.0%, 100.0%, 96.7%, and 93.3%, respectively. Conclusions： In the treatment of AVF with stenosis or thrombosis at or around its anastomosis, puncture via the brachial artery can achieve a high pass rate, a fairly good postoperative patency rate, and a low incidence rate of serious complications, and therefore, the brachial artery is an important approach for the endovascular treatment of dysfunctional fistula.
出处
《西南医科大学学报》
2017年第4期347-350,共4页
Journal of Southwest Medical University
关键词
肱动脉入路
经皮血管腔内成形术
动静脉内瘘失功能
Brachial artery approach
Percutaneous transluminal angioplasty
Functional loss of arteriovenousfistula
