SMART stent for salvage of hemodialysis access grafts
SMART stent for salvage of hemodialysis access grafts
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DOI：
10.1097/01.rvi.0000129915.48500.dc
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发表时间：
2004-10-01
影响因子：
2.9
通讯作者：
Parise, C
中科院分区：
文献类型：
--
作者：
Vogel, PM;Parise, C
目的：评估 SMART 支架治疗血管成形术抵抗性血液透析通路静脉狭窄的效果。 材料和方法：对 64 例聚四氟乙烯移植物患者进行回顾性研究，这些患者在静脉流出道的 69 个位置接受 SMART 支架治疗。支架用于经皮腔内血管成形术后的弹性回缩、静脉破裂或血管成形术后不到3个月的复发性狭窄。当血管造影随访可用时，测量支架内再狭窄的程度。确定初次通畅，并在适用时与同一病变的先前血管成形术治疗进行比较。 结果：SMART支架被放置在15条中心静脉和54条外周静脉中，技术成功率为98％，临床成功率为97％。接受中央支架和外周支架的患者的平均主要通路通畅时间分别为 14.9 个月和 8.9 个月。在 19 名先前接受过血管成形术治疗中央或外周静脉狭窄的患者中，放置 SMART 支架后平均主要通路通畅时间从 2.5 个月增加到 10.6 个月 (P = .0003)。平均 348 天后，29 名患者的血管造影显示平均支架内狭窄率为 55%。唯一与支架相关的并发症发生在一名患有与放置在肘部的 SMART 支架边缘相关的静脉夹层的患者中。结论：SMART 支架对于治疗对标准血管成形术有抵抗力的透析通路静脉狭窄是安全有效的。
PURPOSE: To evaluate the SMART stent for treating angioplasty-resistant hemodialysis access venous stenoses.MATERIALS AND METHODS: A retrospective study of 64 patients with polytetrafluoroethylene grafts who were treated with the SMART stent at 69 locations in the venous outflow tract was undertaken. Stents were used for elastic recoil after percutaneous transluminal angioplasty, venous rupture, or recurrent stenosis less than 3 months after angioplasty. When angiographic follow-up was available, the degree of in-stent restenosis was measured. Primary patency was determined, and, when applicable, compared with that of previous angioplasty treatments of the same lesion.RESULTS: The SMART stent was placed in 15 central veins and 54 peripheral veins, with a 98% technical success rate and a 97% clinical success rate. The mean primary access patency times were 14.9 months and 8.9 months in patients who received central and peripheral stents, respectively. In 19 patients whose central or peripheral venous stenoses were previously treated with angioplasty, the mean primary access patency was increased from 2.5 months to 10.6 months after placement of the SMART stent (P = .0003). Angiography in 29 patients after an average of 348 days showed 55% mean in-stent stenosis. The only stent-related complication occurred in a patient who had venous dissection associated with the edge of a SMART stent placed at the elbow.CONCLUSION: The SMART stent is safe and effective for treating dialysis access venous stenoses that are resistant to standard angioplasty.