Marks Natalie, Hingorani Anil, Ascher Enrico
Maimonides Medical Center, Division of Vascular Surgery, Brooklyn, New York 11219, USA.
Perspect Vasc Surg Endovasc Ther. 2008 Dec;20(4):340-5. doi: 10.1177/1531003508327921. Epub 2008 Nov 19.
Following contemporary trend, various vascular interventions being performed in the office. We describe our office experience with radiofrequency ablation (RFA) of incompetent perforating veins (IPV) and duplex-guided balloon angioplasties of failing/nonmaturing arterio-venous fistulas (AVF). DUPLEX-GUIDED BALLOON ANGIOPLASTIES OF AVF: Eighteen patients with 20 failing arterio-venous (AV) fistulas underwent office duplex-guided balloon angioplasties. Thirteen procedures (65%) were on non-maturing fistulas and the remaining 7 (35%)--in dialyzed patients. Sheath insertion, wire and balloon passage and inflation were guided by duplex only.
We performed 25 radiofrequency ablations of 49 IPVs. Early follow-up scan confirmed total occlusion of 45 (92%) treated IPVs. Patients gender, CEAP class, perforator diameter or GSV patency did not correlate with current procedure failure.
Excellent duplex imaging quality and technical advances in endovascular tools allowed us safely perform AVF balloon angioplasties and RFA of IPVs in the office.
顺应现代趋势，各种血管介入操作可在门诊进行。我们描述了我们在门诊对功能不全的穿通静脉（IPV）进行射频消融（RFA）以及对功能衰竭/未成熟的动静脉内瘘（AVF）进行双功超声引导下球囊血管成形术的经验。
AVF的双功超声引导下球囊血管成形术：18例患者的20个功能衰竭的动静脉（AV）内瘘接受了门诊双功超声引导下球囊血管成形术。其中13例手术（65%）针对未成熟内瘘，其余7例（35%）针对透析患者。仅在双功超声引导下进行鞘管置入、导丝和球囊通过及充盈操作。
IPV的RFA：我们对49条IPV进行了25次射频消融。早期随访扫描证实45条（92%）接受治疗的IPV完全闭塞。患者的性别、CEAP分级、穿通静脉直径或大隐静脉通畅情况与当前手术失败无关。
优异的双功超声成像质量和血管内工具的技术进步使我们能够在门诊安全地进行AVF球囊血管成形术和IPV的RFA。
