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超声引导血管成形术用于血管通路的临床经验。

Clinical experience with ultrasound guided angioplasty for vascular access.

作者信息

Cho Seong, Lee Yu-Ji, Kim Sung-Rok

机构信息

Division of Nephrology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University College of Medicine, Changwon, Korea.

出版信息

Kidney Res Clin Pract. 2017 Mar;36(1):79-85. doi: 10.23876/j.krcp.2017.36.1.79. Epub 2017 Mar 31.

DOI:10.23876/j.krcp.2017.36.1.79
PMID:28393000
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5331978/
Abstract

BACKGROUND

The use of ultrasound guided percutaneous transluminal angioplasty (UG-PTA), which use ultrasound as an imaging modality, is an evolving strategy. But, in Korea, this method is rarely used. We report our experiences with UG-PTA with respect to technical success rates and complication rates compared to conventional PTA (C-PTA), performed between 2010 and 2015 at Samsung Changwon Hospital, Korea.

METHODS

In our series, 53 cases of UG-PTA and 90 cases of C-PTA were reviewed, respectively. Cases of central vein stenosis, cephalic arch stenosis, arterial stenosis and thrombosis were excluded. However, cases of juxta-anastomotic stenosis and outflow vein stenosis were included.

RESULTS

Technical success was achieved in 96.2% (51 of 53) of cases in the UG-PTA group and in 93.3% (84 of 90) of cases in the C-PTA group, respectively ( = 0.710). Technical failure was experienced in a total 8 cases (UG-PTA group: 2/53, 3.8%; C-PTA group: 6/90, 6.7%). No differences were observed in complications.

CONCLUSION

Duplex ultrasound-guided angioplasty for dialysis access in the outpatient setting is feasible, safe, and effective for peripheral venous stenotic lesions. It offers many advantages over conventional angiographic procedures, and, in the future, it has great potential to play a significant role in the management of these challenging patients.

摘要

背景

使用超声作为成像方式的超声引导下经皮腔内血管成形术（UG-PTA）是一种不断发展的策略。但是，在韩国，这种方法很少使用。我们报告了2010年至2015年在韩国三星昌原医院进行的UG-PTA与传统PTA（C-PTA）相比在技术成功率和并发症发生率方面的经验。

方法

在我们的系列研究中，分别回顾了53例UG-PTA病例和90例C-PTA病例。排除中心静脉狭窄、头臂弓狭窄、动脉狭窄和血栓形成的病例。然而，吻合口近端狭窄和流出静脉狭窄的病例被纳入。

结果

UG-PTA组96.2%（53例中的51例）的病例和C-PTA组93.3%（90例中的84例）的病例分别取得了技术成功（P = 0.710）。总共8例出现技术失败（UG-PTA组：2/53，3.8%；C-PTA组：6/90，6.7%）。并发症方面未观察到差异。

结论

门诊环境下双功超声引导的血管成形术用于透析通路对于外周静脉狭窄病变是可行、安全且有效的。它比传统血管造影术有许多优势，并且在未来，它在管理这些具有挑战性的患者方面有很大潜力发挥重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ee/5331978/b67d8a9a4e1e/krcp-36-079f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ee/5331978/1a0666e45464/krcp-36-079f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ee/5331978/e7ff83cc6da0/krcp-36-079f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ee/5331978/a656d27ef4dd/krcp-36-079f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ee/5331978/f3faae21b0fb/krcp-36-079f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ee/5331978/2117ebc97c64/krcp-36-079f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ee/5331978/b67d8a9a4e1e/krcp-36-079f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ee/5331978/1a0666e45464/krcp-36-079f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ee/5331978/e7ff83cc6da0/krcp-36-079f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ee/5331978/a656d27ef4dd/krcp-36-079f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ee/5331978/f3faae21b0fb/krcp-36-079f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ee/5331978/2117ebc97c64/krcp-36-079f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ee/5331978/b67d8a9a4e1e/krcp-36-079f6.jpg

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The key role of color Doppler ultrasound in the work-up of hemodialysis vascular access.彩色多普勒超声在血液透析血管通路检查中的关键作用。
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