Sahni Vikram, Kaniyur Sunil, Malhotra Anmol, Fan Stanley, Blakeney Charles, Fotheringham Tim, Sobeh Mohammed, Matson Matthew
Department of Radiology, Barts and The London NHS Trust, The Royal London Hospital, Whitechapel Road, London, E1 1BB, UK.
Cardiovasc Intervent Radiol. 2005 Nov-Dec;28(6):714-21. doi: 10.1007/s00270-004-0292-1.
The purpose of this study was to evaluate the efficacy and safety of a new hydrodynamic percutaneous thrombectomy catheter in the treatment of thrombosed hemodialysis fistulas and grafts. Twenty-two patients (median age: 47 years; range: 31-79 years) underwent mechanical thrombectomy for thrombosed hemodialysis fistulas or polytetrafluoroethylene (PTFE) grafts. In all cases, an Oasis hydrodynamic catheter was used. Five patients had native fistulas and 17 had PTFE grafts. Six patients required repeat procedures. All patients with native fistulas and 15 of the 17 with PTFE grafts also underwent angioplasty of the venous limb following the thrombectomy. Major outcome measures included technical success, clinical success, primary and secondary patency, and complication rates. Twenty-eight procedures were performed in total. The technical success rate was 100% and 90% and clinical success was 86% and 76% for native fistulas and grafts, respectively. The primary patency at 6 months was 50% and 59% for fistulas and grafts, respectively, and the secondary patency at 6 months was 75% and 70% for fistulas and grafts, respectively. Two patients died of unrelated causes during the follow-up period. The Oasis catheter is an effective mechanical device for the percutaneous treatment of thrombosed hemodialysis access. Our initial success rate showed that the technique is safe in the treatment of both native fistulas and grafts.
本研究的目的是评估一种新型水力驱动经皮血栓切除术导管在治疗血栓形成的血液透析瘘管和移植物中的疗效和安全性。22例患者（中位年龄：47岁；范围：31 - 79岁）因血栓形成的血液透析瘘管或聚四氟乙烯（PTFE）移植物接受了机械血栓切除术。所有病例均使用了Oasis水力驱动导管。5例患者为自体瘘管，17例为PTFE移植物。6例患者需要重复手术。所有自体瘘管患者以及17例PTFE移植物患者中的15例在血栓切除术后还接受了静脉段的血管成形术。主要观察指标包括技术成功率、临床成功率、原发性和继发性通畅率以及并发症发生率。总共进行了28次手术。自体瘘管和移植物的技术成功率分别为100%和90%，临床成功率分别为86%和76%。瘘管和移植物在6个月时的原发性通畅率分别为50%和59%，继发性通畅率分别为75%和70%。2例患者在随访期间死于无关原因。Oasis导管是一种用于经皮治疗血栓形成的血液透析通路的有效机械装置。我们的初始成功率表明该技术在治疗自体瘘管和移植物方面是安全的。
