中心静脉闭塞患者上肢动静脉通路的建立：一种新技术
Placement of Upper Extremity Arteriovenous Access in Patients with Central Venous Occlusions: A Novel Technique.
作者信息
Murga Allen G, Chiriano Jason T, Bianchi Christian, Sheng Neha, Patel Sheela, Abou-Zamzam Ahmed M, Teruya Theodore H
机构信息
Division of Vascular Surgery, Loma Linda University, Loma Linda, CA.
Division of Vascular Surgery, Loma Linda University, Loma Linda, CA.
出版信息
Ann Vasc Surg. 2017 Jul;42:317-321. doi: 10.1016/j.avsg.2016.11.008. Epub 2017 Mar 8.
BACKGROUND
Central venous occlusion is a common occurrence in patients with end-stage renal disease. Placement of upper extremity arteriovenous access in patients with occlusion of the brachiocephalic veins is often not an option. Avoidance of lower extremity vascular access can decrease morbidity and infection.
METHODS
The central venous lesions were crossed centrally via femoral access. The wire was retrieved in the neck extravascularly. A Hemodialysis Reliable Outflow catheter was then placed in the right atrium and completed with an arterial anastomosis.
RESULTS
We describe a novel technique for placing upper extremity arteriovenous access in patients with occlusion of the brachiocephalic veins. This technique was utilized in 3 patients. The technical success was 100%.
CONCLUSIONS
The placement of upper extremity arteriovenous access in patients with central venous occlusions is technically feasible.
背景
中心静脉闭塞在终末期肾病患者中很常见。对于头臂静脉闭塞的患者，上肢动静脉通路的建立通常不是一个选择。避免下肢血管通路可降低发病率和感染风险。
方法
通过股静脉通路经中心穿过中心静脉病变。导丝在颈部血管外取出。然后将血液透析可靠流出导管置于右心房，并完成动脉吻合。
结果
我们描述了一种在头臂静脉闭塞患者中建立上肢动静脉通路的新技术。该技术应用于3例患者。技术成功率为100%。
结论
在中心静脉闭塞患者中建立上肢动静脉通路在技术上是可行的。
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