Hoffer F A, Wyly J B, Fellows K E, Harmon W, Levey R H
Pediatr Radiol. 1986;16(6):456-60. doi: 10.1007/BF02387957.
The patency of vascular access shunts and fistulae has been prolonged by a combined surgical and radiological approach that includes percutaneous transluminal angioplasty (PTA), surgical revision, thrombectomy, and thrombolysis. Over the last 3 years, 35 vascular accesses in 27 patients were found to have angiographic abnormality. PTA was performed 32 times on 19 accesses and 7 PTAs resulted in patent accesses by the end of the study. Surgical revision was performed 9 times on 8 accesses and 2 of the surgical revisions resulted in a patent access by the end of the study. Concerning Thomas femoral shunts, PTA prolonged the patency by 2.2 months and surgical revision by 3.8 months per procedure. Concerning arteriovenous (AV) fistulae, PTA prolonged the patency by 4.3 months and surgical revision by 3.5 months per procedure. A combination of procedures effectively doubles the duration of patency of Thomas femoral shunts and almost triples the duration of patency of AV fistulae in children. Forty-one percent of these accesses remain open 1 year following the initiation of these procedures.
一种包括经皮腔内血管成形术（PTA）、手术修复、血栓切除术和溶栓术的联合外科与放射学方法延长了血管通路分流管和动静脉内瘘的通畅时间。在过去3年中，27例患者的35处血管通路被发现存在血管造影异常。对19处血管通路进行了32次PTA，到研究结束时，7次PTA使血管通路保持通畅。对8处血管通路进行了9次手术修复，到研究结束时，2次手术修复使血管通路保持通畅。关于托马斯股静脉分流管，每次PTA使通畅时间延长2.2个月，每次手术修复使通畅时间延长3.8个月。关于动静脉（AV）内瘘，每次PTA使通畅时间延长4.3个月，每次手术修复使通畅时间延长3.5个月。联合使用这些方法可使儿童托马斯股静脉分流管的通畅时间有效延长一倍，使AV内瘘的通畅时间延长近两倍。在开始这些治疗后的1年，41%的这些血管通路仍保持通畅。
