Verstandig Anthony G, Bloom Allan I, Sasson Talia, Haviv Y S, Rubinger D
Department of Radiology, Hadassah University Hospital, POB 12000, Ein Kerem, Jerusalem 91120, Israel.
Cardiovasc Intervent Radiol. 2003 Jan-Feb;26(1):58-64. doi: 10.1007/s00270-002-1953-6. Epub 2003 Jan 15.
To report our results for the placement of central venous stents in patients undergoing hemodialysis.
Ten Wallstents (Schneider, Bülach, Switzerland) were placed in 10 patients with shunt thrombosis, shunt dysfunction or arm swelling associated with central vein stenosis or occlusion. Technical success, patency and complications were evaluated.
Stent deployment was successful in all cases. In seven cases (70%) there was significant delayed stent shortening. In two of these cases there was also stent migration. All these cases required additional stents. Primary patency rates at 6, 12 and 24 months were 66%, 25% and 0. Twenty-three additional procedures (percutaneous transluminal angioplasty or stenting) were required to achieve secondary patency rates at 6, 12 and 24 months of 100%, 75% and 57%.
Stent placement in the central veins of dialysis patients has a high technical success rate resulting in symptomatic relief and preservation of access. Repeat interventions are required to maintain patency. Significant delayed shortening of the Wallstent occurred in 70% of patients which may have affected the patency rates. Strategies are suggested to avoid this problem.
报告我们在接受血液透析的患者中放置中心静脉支架的结果。
对10例伴有中心静脉狭窄或闭塞相关的分流血栓形成、分流功能障碍或手臂肿胀的患者放置了10个Wallstent支架（瑞士比拉赫施奈德公司生产）。评估技术成功率、通畅率及并发症情况。
所有病例支架置入均成功。7例（70%）出现明显的支架延迟缩短。其中2例还出现了支架移位。所有这些病例均需要额外置入支架。6个月、12个月和24个月时的原发性通畅率分别为66%、25%和0。为使6个月、12个月和24个月时的继发性通畅率分别达到100%、100%和57%，需要进行23次额外操作（经皮腔内血管成形术或支架置入术）。
在透析患者中心静脉放置支架技术成功率高，能缓解症状并保留血管通路。需要重复干预以维持通畅。70%的患者出现了Wallstent支架明显的延迟缩短，这可能影响了通畅率。建议采取策略避免该问题。
