The axillary artery-popliteal vein extended polytetrafluoroethylene graft: a new technique for the complicated dialysis access patient.
The axillary artery-popliteal vein extended polytetrafluoroethylene graft: a new technique for the complicated dialysis access patient.
复制标题
腋动-腘静脉延伸聚四氟乙烯移植物：复杂透析通路患者的新技术。
DOI：
10.1093/ndt/gfg600
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
R. Chang
中科院分区：
文献类型：
--
作者：
F. Calder;E. Chemla;L. Anderson;R. Chang
提高人们对保持透析患者静脉系统完整性的认识水平至关重要。中心静脉狭窄是这一人群的主要问题，有效地排除了受影响的个人从最安全和最有效的血管通路形式-自体上肢瘘。在终末期肾功能衰竭（ESRF）患者中，中心静脉狭窄最常见于锁骨下导管插入术患者，观察到的发生率超过40% [1]。目前中央狭窄的治疗是血管成形术和支架植入术[用于早期（<3个月）复发和弹性病变]。然而，初始失败率为30%，一年内复发是常态[2]。由于下肢存在严重的外周血管疾病，管理此类患者的通路通常变得更加复杂。这就排除了下肢瘘的基础上股血管，因为一个'偷综合征'或坦率坏疽的重大风险。我们报告了一种新的方法来管理病人谁是无法腹膜透析，有中心静脉狭窄和外周血管疾病。
It is essential to increase the level of awareness for the need to preserve the integrity of the venous system in the dialysis patient. Central venous stenosis is a major problem for this population, effectively excluding an affected individual from the safest and most efficacious form of vascular access—a native upper limb fistula. Amongst end-stage renal failure (ESRF) patients central venous stenosis is most common in those who have had subclavian catheterization with an observed incidence of over 40% [1]. Current treatment of central stenosis is by angioplasty and stenting [for early (<3 months) recurrence and elastic lesions]. However, there is an initial failure rate of 30% and recurrence within a year is the norm [2]. Managing the access of such patients is often made more complex by the presence of significant peripheral vascular disease in the lower limbs. This precludes a lower limb fistula based on the femoral vessels because of the significant risk of a ‘steal syndrome’ or frank gangrene. We report a novel approach to managing the patient who is unable to peritoneal dialyse, has central venous stenosis and peripheral vascular disease.