Aytekin Cüneyt, Boyvat Fatih, Yağmurdur Mahmut Can, Moray Gökhan, Haberal Mehmet
Department of Radiology, Başkent University Faculty of Medicine, 06490 Ankara, Turkey.
Eur J Radiol. 2004 Jan;49(1):81-5. doi: 10.1016/S0720-048X(02)00370-4.
To evaluate the efficacy of stent placement for treating upper extremity central venous obstruction in chronic hemodialysis patients.
Between January 1999 and October 2001, we inserted metallic stents into the upper extremity central veins of 14 patients with shunt dysfunction and/or arm swelling. The indications for stent placement were stenosis or occlusion of the central vein in the upper extremity used for dialysis. Six of the individuals were diagnosed with subclavian vein stenosis, and 5 with brachiocephalic vein stenosis. Of the remaining 3 patients, 2 had subclavian vein occlusion, and 1 had left brachiocephalic vein occlusion.
All the stent placement procedures were technically successful, and there were no major complications. Follow-up ranged from 2 weeks to 29 months. The 1-, 3-, 6- and 12-month primary stent patency rates were 92.8, 85.7, 50 and 14.3%, respectively. Repeat interventions, including percutaneous transluminal angioplasty and additional stent placement, were required in 9 patients. The 3-, 6-, 12-month, and 2-year assisted primary stent patency rates were 100, 88.8, 55.5 and 33.3%, respectively.
Endovascular stent placement is an effective alternative to surgery in patients with shunt dysfunction due to obstruction of an upper extremity central vein. Repeated interventions are usually required to prolong stent patency.
评估支架置入术治疗慢性血液透析患者上肢中心静脉阻塞的疗效。
1999年1月至2001年10月期间，我们对14例存在分流功能障碍和/或手臂肿胀的患者的上肢中心静脉置入金属支架。支架置入的指征为用于透析的上肢中心静脉狭窄或闭塞。其中6例诊断为锁骨下静脉狭窄，5例为头臂静脉狭窄。其余3例患者中，2例为锁骨下静脉闭塞，1例为左头臂静脉闭塞。
所有支架置入手术在技术上均获成功，且无严重并发症。随访时间为2周至29个月。1个月、3个月、6个月和12个月的支架初始通畅率分别为92.8%、85.7%、50%和14.3%。9例患者需要重复干预，包括经皮腔内血管成形术和额外的支架置入。3个月、6个月、12个月和2年的辅助支架初始通畅率分别为100%、88.8%、55.5%和33.3%。
对于因上肢中心静脉阻塞导致分流功能障碍的患者，血管内支架置入术是一种有效的手术替代方法。通常需要重复干预以延长支架通畅时间。
