Fabbian F, Malacarne F, Russo G, Galeotti R, Gresta E, Cantelli S, Catizone L
Renal Unit, St. Anna Hospital, Ferrara, Italy.
J Vasc Access. 2007 Apr-Jun;8(2):129-30.
We report a case of a lady affected by autosomal dominant polycystic kidney disease who had been on hemodialyis for 24 years. She has exhausted all options for arterious-venous fistula. The presence of an acquired anatomical abnormality was an obstacle in order to get appropriate blood flow from standard tunnelled femoral catheters. The enlarged right kidney was pushing the inferior vena cava to the left side of the abdomen, and the abnormality was demonstrated by phlebography. Only after placing a cuffed catheter 53 cm long in her left femoral vein we could dialyze efficiently. Venography is mandatory before placing a cuffed catheter especially in uremic patients with long history of access failure, because it saves costs.
我们报告一例患有常染色体显性多囊肾病的女性患者，她已接受血液透析24年。她已用尽所有建立动静脉内瘘的方法。获得性解剖结构异常的存在成为一个障碍，导致无法从标准的带隧道股静脉导管获得合适的血流量。增大的右肾将下腔静脉推向腹部左侧，静脉造影证实了这一异常。仅在她的左股静脉置入一根53厘米长的带袖套导管后，我们才能够有效地进行透析。在置入带袖套导管之前，尤其是对于有长期血管通路失败病史的尿毒症患者，静脉造影是必不可少的，因为这样可以节省费用。
