经皮穿刺球囊扩张治疗动静脉内瘘血栓形成30例

Percutaneous Ballon Dilation in the Treatment of Arteriovenous Fistula Thrombosis: Report of 30 Cases

目的探讨经皮穿刺球囊扩张治疗前臂动静脉内瘘血栓形成的有效性和安全性。方法我科2017年6~12月对30例动静脉内瘘血栓形成,采用经患肢头静脉穿刺置管,经血管鞘导入高压球囊对闭塞段进行扩张(压力>20atm)。结果30例经球囊扩张治疗后均成功开通,未发生出血、血管破裂、肺栓塞。30例术后随访6~13个月,25例动静脉内瘘维持通畅,5例动静脉内瘘再次血栓形成,其中3例经再次球囊扩张治疗后恢复通畅,2例动静脉内瘘未能开通。结论经皮穿刺球囊扩张是治疗前臂动静脉内瘘血栓形成安全、有效的方法。

Objective To evaluate the efficacy and safety of percutaneous ballon dilation in the treatment of forearm arteriovenous thrombosis.Methods A total of 30 patients with arteriovenous fistula thrombosis from June 2017 to December 2017 in this hospital were reviewed.A puncture catheterization was performed through the cephalic vein of the affected limb,and the occluded section was dilated by introducing high-pressure balloon through the sheath tube (pressure>20 atm).Results All the 30 patients were successfully treated with balloon dilation,without bleeding,vascular rupture,or pulmonary embolism.All the patients were followed up for 6-13 months.The arteriovenous fistula remained unobstructed in 25 cases,and thrombosis recurred in 5 cases.Among them,3 cases recovered after balloon dilation and 2 cases failed to open arteriovenous fistula.Conclusion Percutaneous balloon dilation is a safe and effective method for the treatment of forearm arteriovenous fistula thrombosis.