Short- and long-term functional effects of percutaneous transluminal angioplasty in hemodialysis vascular access.
Short- and long-term functional effects of percutaneous transluminal angioplasty in hemodialysis vascular access.
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经皮腔内血管成形术对血液透析血管通路的短期和长期功能影响。
DOI：
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发表时间：
2002
影响因子：
13.6
通讯作者：
P. Blankestijn
中科院分区：
文献类型：
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作者：
J. van der Linden;J. H. Smits;J. Assink;D. Wolterbeek;J. Zijlstra;G. D. de Jong;M. A. van den Dorpel;P. Blankestijn
经皮腔内血管成形术（PTA）的疗效通常用血管造影结果来表示。访问流量（Qa）测量提供了一种手段来量化功能的影响。本研究旨在评价PTA的短期功能和血管造影效应，并确定随访期间功能效应的持续时间。入选了有资格接受PTA（Qa值<600 ml/min）的动静脉移植物（AVG）或动静脉瘘（AVF）患者。超声稀释Qa测量前不久PTA和定期PTA后，开始1周后的程序。短期效应表现为Qa的增加和狭窄的减少。远期疗效以PTA后的通畅率和Qa降低表示。分析了60例患者（65例AVG和33例AVF）的98例PTA手术。AVG的Qa从371 +/- 17改善至674 +/- 30 ml/min，AVF的Qa从304 +/- 24改善至638 +/- 51 ml/min（均P < 0.0001）。在66%（AVG）和50%（AVF）的病例中，Qa增加到>600 ml/min。AVG的狭窄程度从65 +/- 3降至17 +/- 2%，AVF的狭窄程度从72 +/- 5降至23 +/- 7%（均P < 0.005）。狭窄缩小程度与Δ Qa无相关性（r（2）= 0.066）。PTA后6个月的无辅助通畅率，AVG为25%，AVF为50%。AVG和AVF的Qa分别降低3.7 +/- 0.8 ml/min/d和1.8 +/- 0.9 ml/min/d。PTA前Qa值和DeltaQa值与随后Qa值的降低相关（P < 0.005）。总之，PTA后Qa增加，但在相当大比例的病例中，未达到>600 ml/min的水平。PTA前Qa值和Qa增加与长期结局相关，而血管造影结果则无关。这些数据与文献数据相结合，表明PTA存在最佳时机。
The efficacy of percutaneous transluminal angioplasty (PTA) is usually expressed as the angiographic result. Access flow (Qa) measurements offer a means to quantify the functional effects. This study was performed to evaluate the short-term functional and angiographic effects of PTA and to determine the longevity of the functional effects during the follow-up period. Patients with an arteriovenous graft (AVG) or an arteriovenous fistula (AVF) who were eligible for PTA (Qa values of <600 ml/min) were included. Ultrasound-dilution Qa measurements were obtained shortly before PTA and periodically after PTA, beginning 1 wk after the procedure. The short-term effects were expressed as the increase in Qa and the reduction of stenosis. The long-term effects were expressed as patency and the decrease in Qa after PTA. Ninety-eight PTA procedures for 60 patients (65 AVG and 33 AVF) were analyzed. Qa improved from 371 +/- 17 to 674 +/- 30 ml/min for AVG and from 304 +/- 24 to 638 +/- 51 ml/min for AVF (both P < 0.0001). In 66% (AVG) and 50% (AVF) of cases, Qa increased to levels of >600 ml/min. The degree of stenosis decreased from 65 +/- 3 to 17 +/- 2% for AVG and from 72 +/- 5 to 23 +/- 7% for AVF (both P < 0.005). The reduction of stenosis was not correlated with DeltaQa (r(2) = 0.066). Six-month unassisted patency rates after PTA were 25% for AVG and 50% for AVF. The decreases in Qa were 3.7 +/- 0.8 ml/min per d for AVG and 1.8 +/- 0.9 ml/min per d for AVF. Qa values before PTA and DeltaQa were correlated with the subsequent decrease in Qa (P < 0.005). In conclusion, Qa increases after PTA but, in a substantial percentage of cases, not to levels of >600 ml/min. Qa values before PTA and the increase in Qa were correlated with long-term outcomes, whereas angiographic results were not. These data, combined with literature data, suggest that there is optimal timing for PTA.
影响因子：
19.6
作者：
Neyra, NR;Ikizler, TA;Hakim, RM
通讯作者：
Hakim, RM