Miller Gregg Arthur, Friedman Alexander, Khariton Aleksandr, Jotwani Manish C, Savransky Yevgeny
American Access Care of Brooklyn, Brooklyn, NY, USA.
J Vasc Access. 2010 Apr-Jun;11(2):115-21. doi: 10.1177/112972981001100206.
Breast edema is a rare complication in hemodialysis patients with central venous occlusions. The present study sought to determine whether coil embolization of the long thoracic vein is an effective long-term treatment for this pathology.
The study patients were 6 female hemodialysis patients whose primary clinical manifestation of central vein occlusion was breast edema. When conservative treatment (allowing collaterals to dilate over time), as well as recanalization of occlusions through angioplasty with or without stent placement, failed to alleviate symptoms, patients underwent coil embolization of the long (lateral) thoracic vein.
In 4 of the 6 cases, the breast edema was completely resolved without recurrence, while the other 2 patients experienced durable symptomatic improvement with only mild residual swelling. Average follow-up was 22 months. There were no adverse sequelae and none of the patients experienced increased swelling elsewhere following the coil embolization procedure.
Coil embolization of the long thoracic vein effectively alleviates breast edema in hemodialysis patients with elevated venous hydrostatic pressure due to central venous occlusions.
乳腺水肿是中心静脉闭塞的血液透析患者中一种罕见的并发症。本研究旨在确定胸长静脉的弹簧圈栓塞术是否是针对这种病症的一种有效的长期治疗方法。
研究对象为6名女性血液透析患者，其中心静脉闭塞的主要临床表现为乳腺水肿。当保守治疗（让侧支循环随时间扩张）以及通过血管成形术（无论是否置入支架）再通闭塞血管均未能缓解症状时，患者接受了胸长（外侧）静脉的弹簧圈栓塞术。
6例患者中有4例乳腺水肿完全消退且未复发，另外2例患者症状持续改善，仅残留轻度肿胀。平均随访时间为22个月。未出现不良后遗症，且在弹簧圈栓塞术后，没有患者在其他部位出现肿胀加重的情况。
胸长静脉的弹簧圈栓塞术可有效缓解因中心静脉闭塞导致静脉静水压升高的血液透析患者的乳腺水肿。
