高压球囊与普通外周球囊治疗前臂自体动静脉瘘狭窄长期通畅率的对照研究

Comparison of primary patency following high-pressure balloon versus conventional balloon angioplasty for treatment of stenosis in hemodialysis arteriovenous fistulae

目的比较高压球囊与普通外周球囊治疗前臂自体动静脉瘘狭窄1年后的通畅率。方法将40例前臂自体人工动静脉瘘狭窄的患者,随机分成高压球囊组和普通球囊组,每组20例。对患者行经皮静脉血管成形术,随访1年患者的手术后通畅率和瘘管的流量。结果与普通球囊组比较,高压球囊组患者的手术成功率高(95.00%vs 80.00%),1年后的通畅率高(30%vs 10%),差异均有统计学意义(P=0.033,P=0.04)。结论高压球囊在治疗前臂自体人工动静脉瘘狭窄,较普通外周动脉球囊长期通畅率和手术成功率有明显优势。

Objective To compare primary patency rates achieved by conventional balloon angioplasty and high-pressure balloon angioplasty in treatment of stenosis of arteriovenous fistulae （AVF） in patients with hemodialysis. Methods Forty hemodialysis patients with native AVF stenosis were randomly assigned to undergo high-pressure balloon angioplasty （n = 20） or conventional balloon angioplasty （ n = 20）. Patients were followed up for 1 year, the duration of patency and the flow rate of fistula were compared between two groups. Results Technical success rate of high-pressure balloon angioplasty was higher than that of conventional balloon angioplasty（95.0% vs 80. 0%, P = 0. 033 ）. The 1-year patency rate of high-pressure balloon angioplasty was higher than that of conventional balloon angioplasty （30% vs 10%, P = 0.04）. Conclusion Compared with conventional balloon angioplasty, high-pressure balloon angioplasty can improve success rate of surgery and long-term patency rate in treatment of stenosis in hemodialysis arteriovenous fistulae.