Piccolo C, Madden N, Famularo M, Domer G, Mannella W
Philadelphia College of Osteopathic Medicine, Fort Washington, PA, USA
Philadelphia College of Osteopathic Medicine, Fort Washington, PA, USA.
Vasc Endovascular Surg. 2015 Jul-Aug;49(5-6):124-8. doi: 10.1177/1538574415600532. Epub 2015 Aug 27.
Upper extremity native arteriovenous fistulas (AVFs) continue to be the standard of care for hemodialysis patient's access. Although autogenous fistulas are superior to catheters and synthetic grafts, they are not without their own complications. One complication is venous aneurysms that can lead to skin erosion, bleeding, and site loss. Although traditionally repaired with ligation, interposition grafts, or stent placement, in this article, we discuss our experience with aneurysmorrhaphy utilizing a thoracoabdominal (TA) stapler. Thirteen aneurysms were treated with the TA stapler at a single, nonuniversity hospital for all patients from 2012 to 2014. The average aneurysm diameter was 3.6 cm, and the average fistula age was 57.9 months. There were no bleeding complications or recurrences. The primary patency was 80% at 6 months, with a primary assisted patency of 90% during the same time frame. Aneurysmorrhaphy with the TA stapler appears to be a safe and viable option for the treatment of venous aneurysms associated with AVFs.
上肢自体动静脉内瘘（AVF）仍然是血液透析患者血管通路的标准选择。尽管自体动静脉内瘘优于导管和人工血管，但也并非没有自身的并发症。其中一种并发症是静脉瘤，可能导致皮肤糜烂、出血和内瘘丧失。虽然传统上采用结扎、搭桥移植或支架置入等方法进行修复，但在本文中，我们将讨论使用胸腹（TA）吻合器进行动脉瘤缝合术的经验。2012年至2014年期间，在一家非大学医院，对所有患者的总共13个动脉瘤采用TA吻合器进行了治疗。动脉瘤平均直径为3.6厘米，动静脉内瘘平均使用时长为57.9个月。未出现出血并发症或复发情况。6个月时的初次通畅率为80%，同期初次辅助通畅率为90%。使用TA吻合器进行动脉瘤缝合术似乎是治疗与动静脉内瘘相关的静脉瘤的一种安全可行的选择。
