Dorado^(TM)高压球囊治疗自体动静脉内瘘再闭塞的疗效观察

Observation of the Efficacy of DoradoTMHigh Pressure Balloon in the Treatment of Autologous Arteriovenous Fistula Occlusion

目的探讨Dorado^(TM)高压球囊扩张导管及普通球囊扩张导管在自体动静脉内瘘后狭窄及闭塞的临床效果。方法回顾性分析我科2013年6月至2014年12月收治的21例患者,13例采用普通球囊,8例采用Dorado^(TM)球囊,并对术后效果进行对比分析。结果 20例(95.24%)患者取得技术成功,术后狭窄度低于30%,术后血流量大于200m L/h,满足透析需要。1例(4.76%)无法开通闭塞段后转行人工血管内瘘术。普通球囊组7例(53.85%)术后狭窄低于10%,5例(38.46%)狭窄介于10%~30%,1例(4.76%)未开通闭塞;术后3个月4例(30.77%)狭窄低于10%,6例(46.15%)狭窄介于10%~30%,3例(23.08%)出现再闭塞。Dorado^(TM)球囊组7例(87.50%)术后狭窄低于10%,1例(12.5%)狭窄介于10%~30%,0例(0.00%)未开通;术后3个月6例(75.00%)狭窄低于10%,2例(25.00%)狭窄介于10%~30%,无再闭塞。所有患者术中均未出现血栓形成、出血或血管破裂等并发症。结论 Dorado^(TM)球囊相较普通球囊具有更好的扩张效果,但因随访时间及病例量局限,结果尚需继续观察。

Objective To investigate the clinical effect of Dorado^TM high pressure balloon dilatation catheter and conventional balloon dilatation catheter in the treatment of stenosis and occlusion after autologous arteriovenous fistula.Methods In this retrospective analysis,we compared outcomes in 21 patients with stenosis and occlusion after autologous arteriovenous fistula who received Dorado^TM high pressure balloon dilatation catheter（ 8） and who received conventional balloon dilatation catheter（ 13）.Results In 20 patients（ 95. 24%）,the technique was successful and the stenosis degree was less than 30%,and the blood flow rate was more than 200 ml / h,which satisfied the needs of dialysis.In conventional balloon group,stenosis less than 10% occurred in 7（ 53. 85%） after operation and in 4（ 30. 77%） 3 months after treatment,and postoperative stenosis between 10% to 30% occurred in 5（ 38. 46%）,and treatment failure occurred in 1（ 4. 76%）.In Dorado^TM group,stenosis less than 10% occurred in 7（ 87. 50%）after operation and in 6（ 75%） 3 months after treatment,stenosis between 10% to 30% occurred in 1（ 12. 5%） after operation and in 2（ 25%） 3 months after treatment. No thrombosis,hemorrhage or rupture of blood vessels occurred in all patients.Conclusion Compared with the ordinary balloon Dorado^TM balloon had a better effect of expansion,but the results still need to be continuously observed because of limitations of follow-up time and the number of cases.