Abreo Kenneth, Buffington Mary, Sachdeva Bharat
School of Medicine, LSU Health Shreveport, Shreveport, LA, USA.
J Vasc Access. 2018 Jul;19(4):337-340. doi: 10.1177/1129729818760979. Epub 2018 Mar 12.
The arteriovenous fistula is currently the best permanent access for the hemodialysis patient. Unfortunately, stenosis impairs maturation, long-term survival, and function of the arteriovenous fistula. Angioplasty currently is the best procedure for the treatment of immature and dysfunctional arteriovenous fistulas. In this review, the authors discuss the optimum time to evaluate arteriovenous fistulas for maturity, methods of evaluation for maturity, and the role of angioplasty in salvaging immature arteriovenous fistulas. The review also discusses the effect of stenosis on dysfunction in mature arteriovenous fistulas and the role of angioplasty to treat this complication. Finally, the impact of cutting balloons and drug-eluting balloons in the treatment of resistant and recurrent stenosis, respectively, is also discussed.
动静脉内瘘目前是血液透析患者最佳的永久性血管通路。不幸的是，狭窄会损害动静脉内瘘的成熟度、长期存活及功能。血管成形术目前是治疗未成熟及功能不良动静脉内瘘的最佳方法。在本综述中，作者讨论了评估动静脉内瘘成熟度的最佳时机、成熟度的评估方法，以及血管成形术在挽救未成熟动静脉内瘘中的作用。该综述还讨论了狭窄对成熟动静脉内瘘功能障碍的影响以及血管成形术在治疗此并发症中的作用。最后，还讨论了切割球囊和药物洗脱球囊分别在治疗难治性和复发性狭窄中的作用。
