Rambhia Sagar, Janko Matthew, Hacker Robert I
Case Western Reserve University School of Medicine, Cleveland, OH.
Case Western Reserve University School of Medicine, Cleveland, OH; Division of Vascular Surgery and Endovascular Therapy, University Hospitals Cleveland Medical Center, Cleveland, OH.
Ann Vasc Surg. 2018 Jul;50:297.e1-297.e3. doi: 10.1016/j.avsg.2017.11.043. Epub 2018 Feb 15.
Central venous occlusion is conventionally managed with balloon angioplasty, stent extension, or sharp recanalization. Here, we describe recanalization of a chronically occluded innominate vein using excimer laser after conventional techniques were unsuccessful. Patient clinical improvement and fistula patency have been sustained 2 years postintervention. This technique may provide new hemodialysis access options for patients who would not otherwise be candidates for hemodialysis access on the ipsilateral side of a central venous occlusion.
中心静脉闭塞传统上采用球囊血管成形术、支架延伸术或锐性再通术进行治疗。在此，我们描述了在传统技术失败后，使用准分子激光对一条慢性闭塞的无名静脉进行再通的情况。干预后2年，患者的临床症状持续改善，动静脉内瘘保持通畅。对于那些在中心静脉闭塞同侧原本不适合进行血液透析通路建立的患者，这项技术可能提供新的血液透析通路选择。
