Royal Bournemouth and Christchurch Hospitals, Bournemouth, UK.
Clin Radiol. 2011 Jan;66(1):1-12. doi: 10.1016/j.crad.2010.05.010. Epub 2010 Sep 15.
Patent vascular access is a prerequisite for adequate haemodialysis, and is a major determinant of quality of life and long-term survival of patients with end-stage renal disease. Autogenous haemodialysis fistulas (AVFs) have demonstrated superior clinical outcome when compared to synthetic grafts, but both types of access remain susceptible to venous stenoses, and consequent thrombotic occlusion. Recent publications have reported primary patency rates of up to 100% following percutaneous de-clotting of AVFs incorporating techniques such as pharmacological thrombolysis, mechanical thrombectomy, and thrombo-aspiration. Endovascular management also provides information regarding the underlying cause of access thrombosis, with option to treat. Consequently, there has been a paradigm shift in the management of fistula thrombosis, with interventional radiology assuming a lead role in initial salvage procedures. This article will attempt to provide the reader with an insight into the multiple radiological techniques that can be employed to salvage a thrombosed AVF based on current published literature.
专利血管通路是充分血液透析的前提，是终末期肾病患者生活质量和长期生存的主要决定因素。与合成移植物相比，自体血液透析瘘（AVF）显示出更好的临床结果，但这两种类型的通路仍然容易发生静脉狭窄，进而导致血栓闭塞。最近的出版物报告称，经皮去栓术治疗 AVF 的初次通畅率高达 100%，其中包括药物溶栓、机械血栓切除术和血栓抽吸等技术。血管内治疗还提供了有关通路血栓形成的潜在原因的信息，并可选择进行治疗。因此，在瘘血栓形成的管理方面已经发生了范式转变，介入放射学在初始抢救程序中发挥主导作用。本文将尝试根据现有文献，为读者提供了解可用于抢救血栓形成的 AVF 的多种放射学技术的机会。
