Park Jae Young, Yoo Chang Hyun
Busan Vascular Clinic, Busan, Korea.
Vasc Specialist Int. 2015 Mar;31(1):20-4. doi: 10.5758/vsi.2015.31.1.20. Epub 2015 Mar 31.
To report result and usefulness of immediate postoperative balloon angioplasty of de novo arteriovenous fistula (AVF) with limited flow just after creation.
From January 1, 2012 to March 31, 2014, 1,270 patients received native AVF creations in a single vascular clinic. In twenty-four patients (1.9% of total AVF creation), immediate postoperative balloon angioplasty was performed because of limited flow on palpation (only pulsation or no thrill) just after AVF creation. Medical records were reviewed retrospectively; technical success (restoration of AVF flow)/clinical success (growing as functional AVF) rate, maturation time, primary patency rate and fistula survival outcome were analyzed during a mean 10.8 months of follow-up.
Technical/clinical success rate was 95.8% (23/24 cases); AVF flow was restored after balloon angioplasty, and all the flow-restorated AVFs grew as functional AVFs with mean±standard deviation, 4.5±1.5 weeks of maturation time. In seven (30.4%) patients, a secondary balloon angioplasty was needed to enhance maturation. The overall primary patency after immediate postoperative balloon angioplasty was 69.6% at 1 and 6 months and 59.0% at 12 months. There was 1 complication (operation site hematoma).
Immediate postoperative balloon angioplasty for salvage of newly-placed, flow-limiting native AVF is a useful, effective and safe procedure.
报告在动静脉内瘘（AVF）创建后即刻对新发且流量受限的AVF进行术后即刻球囊血管成形术的结果及效用。
2012年1月1日至2014年3月31日，1270例患者在一家血管诊所接受了自体AVF创建。在24例患者（占AVF创建总数的1.9%）中，由于在AVF创建后即刻触诊时流量受限（仅可触及搏动或无震颤），进行了术后即刻球囊血管成形术。对病历进行回顾性分析；在平均10.8个月的随访期间，分析技术成功率（AVF流量恢复）/临床成功率（成长为功能性AVF）、成熟时间、初级通畅率及内瘘存活结果。
技术/临床成功率为95.8%（23/24例）；球囊血管成形术后AVF流量得以恢复，所有流量恢复的AVF均成长为功能性AVF，平均成熟时间为4.5±1.5周（均值±标准差）。7例（30.4%）患者需要进行二次球囊血管成形术以促进成熟。术后即刻球囊血管成形术后1个月和6个月时的总体初级通畅率为69.6%，12个月时为59.0%。发生了1例并发症（手术部位血肿）。
对新放置的、流量受限的自体AVF进行术后即刻球囊血管成形术是一种有用、有效且安全的手术。
