Cutting balloon angioplasty for primary treatment of hemodialysis fistula venous stenoses: preliminary results.
Cutting balloon angioplasty for primary treatment of hemodialysis fistula venous stenoses: preliminary results.
复制标题
切割球囊血管成形术用于血液透析瘘静脉狭窄的初步治疗：初步结果。
DOI：
10.1097/01.rvi.0000144868.50440.8a
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
S. Papura
中科院分区：
文献类型：
--
作者：
J. Singer;S. Papura
目的
目的：评价切割球囊作为经皮腔内血管成形术治疗血液透析通路狭窄的疗效。
材料和方法
对有症状的血液透析患者进行了一项前瞻性研究，他们的血液透析通道的狭窄程度达到或超过50%。如果不存在使用切割球囊的禁忌症，则使用切割球囊治疗狭窄，并使用预期血管直径与球囊直径之间的最大比例1：1.1。在切割球囊扩张至全直径后残余狭窄超过30%的情况下，使用常规球囊进行术后扩张。随访患者探视功能。29例患者42处狭窄在切割球囊血管成形术后获得6个月的随访期。
结果
技术和临床成功率均为100%。有3例出现轻微局部渗出：2例在球囊放气后持续疼痛，因此接受了球囊压迫治疗，症状和血管造影结果得到缓解。在两个病例中，弹性反冲需要放置支架来纠正狭窄。在6个月时，22名患者(76%)仍处于初级通畅类别。包括那些有初级辅助通畅者，26名患者(90%)，另外一名患者有二次通畅性，总计93%。两名患者死于与透析没有直接关系的原因。
结论
技术和临床的高度成功可能反映了缺乏重大并发症。6个月的随访结果与其他系列的结果一致。进一步的随访将显示这种技术是否会在长期内产生更好的结果。
PURPOSE
To assess the efficacy of the cutting balloon as the primary tool in percutaneous transluminal angioplasty of hemodialysis access stenoses.
MATERIALS AND METHODS
A prospective study of symptomatic patients with stenoses of 50% or more in their hemodialysis accesses was undertaken. Provided that no contraindication to the use of cutting balloons existed, the stenoses were treated with the cutting balloon with use of a maximum of a 1:1.1 ratio between expected vessel diameter and balloon diameter. In cases in which dilation to the full diameter of the cutting balloon left a greater than 30% residual stenosis, postprocedural dilation with conventional balloons was carried out. Patient access function was followed. Twenty-nine patients with 42 stenoses have now reached 6 months of follow-up after cutting balloon angioplasty.
RESULTS
Technical and clinical success rates were 100%. Slight local extravasation occurred in three cases: two had continued pain after the balloon was deflated and were therefore treated with balloon compression with resolution of symptoms and angiographic findings. In two cases, elastic recoil required stent placement to correct the stenosis. At 6 months, 22 patients (76%) remain in the primary patency category. Inclusion of those with primary assisted patency yields 26 patients (90%), and an additional patient had secondary patency, for a total of 93%. Two patients died of causes not directly related to dialysis.
CONCLUSION
The high degree of technical and clinical success likely reflects the lack of major complications. The 6-month follow-up results match those of other series. Further follow-up will show whether this technique produces better results over the long term.