Flow in hemodialysis grafts after angioplasty: Do radiologic criteria predict success?
Flow in hemodialysis grafts after angioplasty: Do radiologic criteria predict success?
复制标题
血管成形术后血液透析移植物的血流：放射学标准能否预测成功？
DOI：
10.1046/j.1523-1755.2001.0590051974.x
复制
发表时间：
2001
影响因子：
19.6
通讯作者：
T. Vesely
中科院分区：
文献类型：
--
作者：
S. Ahya;D. Windus;T. Vesely
背景
静脉狭窄经皮血管成形术的解剖学成功取决于血管横截面直径的改善。成功的结果定义为残余狭窄<30%。本研究的目的是确定静脉狭窄的血管造影评估是否与血管成形术后移植血流的变化相关。
方法
22 名移植物内血流量减少（<700 mL/min）的血液透析患者接受了诊断性瘘管造影和血管成形术。所有移植物在手术时均已获得专利。使用超声波稀释技术在血管成形术之前和之后测量移植物内血流量。血管成形术后移植血流的变化与治疗狭窄的形态变化相关。
结果
血管成形术前和血管成形术后移植物的平均血流量分别为 457 +/- 136 和 818 +/- 202 mL/min。血管成形术前的平均狭窄程度为 74 +/- 15%，扩张后为 18 +/- 14%（P < 0.001）。与血管成形术后血流量显着相关的唯一变量是血管成形术前血流量（r2 = 0.22，P < 0.001）。血管成形术后血流量与移植物中测量的最高记录血流量（798 +/- 213 mL/min，P = NS）没有显着差异。血流量的变化与狭窄百分比的变化之间没有显着相关性。
结论
静脉狭窄血管成形术后，移植物血流量最接近地由术前血流量预测，并且与该移植物中测得的最高记录血流量相似。评估血管成形术成功的血管造影标准并不能预测血流的变化。
BACKGROUND
The anatomic success of percutaneous angioplasty of venous stenosis is determined by the improvement in cross-sectional diameter of the vessel. A successful outcome is defined as a residual stenosis of <30%. The purpose of this study was to determine whether the angiographic assessment of a venous stenosis correlates with the change in graft blood flow following angioplasty.
METHODS
Twenty-two hemodialysis patients with decreased intragraft blood flow (<700 mL/min) underwent diagnostic fistulography and angioplasty. All grafts were patent at the time of the procedure. Intragraft blood flow was measured before and after angioplasty using the ultrasonic dilution technique. Change in graft blood flow after angioplasty was correlated to the morphologic changes of the treated stenosis.
RESULTS
The mean preangioplasty and postangioplasty graft blood flows were 457 +/- 136 and 818 +/- 202 mL/min, respectively. The mean degree of stenosis before angioplasty was 74 +/- 15% and 18 +/- 14% after dilation (P < 0.001). The only variable that significantly correlated with postangioplasty blood flow was preangioplasty flow (r2 = 0.22, P < 0.001). The postangioplasty blood flow was not significantly different than the highest recorded blood flow measured in that graft (798 +/- 213 mL/min, P = NS). There was no significant correlation between the change in blood flow and the change in percentage of stenosis.
CONCLUSION
Following angioplasty of a venous stenosis, the graft blood flow is most closely predicted by the preprocedural blood flow and is similar to the highest recorded blood flow ever measured in that graft. Angiographic criteria to assess the success of angioplasty are not predictive of changes in blood flow.