肾动静脉瘘的腔内治疗

Endovascular treatment of renal arteriovenous fistula

目的评估腔内治疗肾动静脉瘘(RAVF)的安全性及有效性。方法回顾性分析13例接受腔内治疗的RAVF患者资料。结果对13例RAVF患者行腔内治疗的技术成功率为100%(13/13),栓塞病变动脉共23条,治疗应用弹簧圈共78个。腔内治疗对RAVF患者血尿的有效率为100%(11/11),腰部疼痛有效率为85.71%(6/7),高血压有效率为100%(3/3)。RAVF患者术前血肌酐平均值[(94.50±29.82)μmol/L]与术后血肌酐平均值[(94.25±28.85)μmol/L]差异无统计学意义(P>0.05)。术后无严重并发症,仅3例出现低热,2例患侧腰部不适。术后平均随访(37.23±16.78)个月。2例失访,余11例患者均无复发症状。结论腔内治疗对RAVF患者安全、有效且并发症较少。

Objective To evaluate the safety and efficacy of endovascular treatment for renal arteriovenous fistula（RAVF）.Methods Data of 13 patients with RAVF were analyzed retrospectively.All the patients underwent angiography and endovascular treatment.Results The technical success rate of endovascular treatment was 100%（13/13）.A total of23 arteries received selective arterial embolization with 78 coils.After treatment,the clinical symptom remission rate of hematuria,back pain and hypertension was 100%（11/11）,85.71%（6/7）and 100%（3/3）,respectively.There was no statistical difference of serum creatinine before（[94.50±29.82]μmol/L）and after treatment（[94.25±28.85]μmol/L,P0.05）.No serious complication was found.There were only 3cases of low fever and 2cases complained of lower back pain postoperatively.The mean follow-up time was（37.23±16.78）months.And 2cases were lost follow up,while the rest of11 cases had no recurrence of symptoms.Conclusion As the safe and effective procedure,endovascular treatment can be used for the treatment of RAVF.