Bruno Simona, Remuzzi Giuseppe
Department of Medicine and Transplantation, Azienda Ospedaliera, Ospedali Riuniti di Bergamo, Bergamo, Italy.
J Nephrol. 2006 May-Jun;19(3):280-5.
The most common complication of permanent vascular access is thrombosis, which accounts for 80 to 85% of AV access loss. Treatment of venous stenosis by percutaneous angioplasty, endovascular stents and surgical revision is clinically important but many strategies to prevent thrombosis have been employed, such as antiplatelet agents, systemic anticoagulation, and experimental therapies as fish oils, heparinoids, clopidogrel, renin-angiotensin system antagonists, calcium channel blockers, alpha adrenergic antagonists, homocysteine-lowering agents and beta-hydroxybetamethyglutaryl coenzyme-A reductase inhibitors. Future but promising approaches are endovascular radiation and gene therapy.
永久性血管通路最常见的并发症是血栓形成，其导致80%至85%的动静脉通路失功。经皮血管成形术、血管内支架置入术和外科修复术治疗静脉狭窄在临床上很重要，但也采用了许多预防血栓形成的策略，如抗血小板药物、全身抗凝以及鱼油、类肝素、氯吡格雷、肾素-血管紧张素系统拮抗剂、钙通道阻滞剂、α肾上腺素能拮抗剂、降低同型半胱氨酸药物和β-羟基-β-甲基戊二酰辅酶A还原酶抑制剂等实验性疗法。未来但很有前景的方法是血管内放射治疗和基因治疗。
