Samett Evan J, Hastie Joshua, Chopra Paramjit Romi, Pradhan Sujit, Ahmad Iftikhar, Chiramel Terence, Joseph Reginald
Midwest Institute for Minimally Invasive Therapies, Melrose Park, Illinois, USA.
J Vasc Access. 2011 Jan-Mar;12(1):9-12. doi: 10.5301/jva.2010.6018.
The surgically placed dialysis arteriovenous fistula (AVF) is considered by the Kidney Disease Outcomes Quality Initiative (KDOQI)and the Fistula First Breakthrough Initiative to be the ideal choice for hemodialysis access. A significant number of newly placed AVFs either slowly or never adequately mature sufficiently to provide for adequate dialysis. The balloon-assisted maturation (BAM) procedure utilizes serial angioplasty to promote and accelerate AVF maturation. We present a minimally invasive AVF maturation technique utilizing angioplasty, stent-graft, and coil embolization.
A 41-year-old white woman presented with an nonmaturing AVF with multiple venous outflow channels. An adequately functioning AVF was achieved after 2 treatments including coil embolization, angioplasty, and stent-graft placement.
Adequate thrill and dialysis flow was achieved. Patient has done well during short-term follow-up without further intervention.
BAM techniques can be an effective tool to help a dialysis patient achieve an adequately mature AVF. Additional vascular interventional techniques may be utilized to further improve clinical results. For the purpose of this report we call this technique "augmented balloon-assisted maturation," or aBAM.
手术置入的动静脉内瘘（AVF）被肾脏病预后质量倡议组织（KDOQI）和内瘘优先突破倡议组织视为血液透析通路的理想选择。相当数量的新置入AVF要么成熟缓慢，要么根本无法充分成熟以提供足够的透析。球囊辅助成熟（BAM）程序利用系列血管成形术促进和加速AVF成熟。我们介绍一种利用血管成形术、覆膜支架和弹簧圈栓塞的微创AVF成熟技术。
一名41岁白人女性因AVF不成熟且有多个静脉流出道前来就诊。经过包括弹簧圈栓塞、血管成形术和覆膜支架置入在内的2次治疗后，获得了功能良好的AVF。
实现了足够的震颤和透析血流量。患者在短期随访期间情况良好，无需进一步干预。
BAM技术可以成为帮助透析患者获得充分成熟AVF的有效工具。可利用其他血管介入技术进一步改善临床结果。出于本报告的目的，我们将此技术称为“增强球囊辅助成熟”，即aBAM。
