Schwab S J, Saeed M, Sussman S K, McCann R L, Stickel D L
Department of Medicine, Duke University Medical Center, Durham, North Carolina.
Kidney Int. 1987 Sep;32(3):395-8. doi: 10.1038/ki.1987.223.
Since 1984, percutaneous transluminal angioplasty (PTA) utilizing high pressure balloon catheters has been used as an initial approach to restore patency of PTFE (polytetrafluoroethylene, GORE-TEX) hemodialysis vascular access grafts. Seventeen stenotic lesions detected by fistulogram underwent elective PTA. Twelve of these lesions were detected after thrombectomy and five were detected because of increased venous pressures during dialysis. Fourteen attempts at PTA were completely successful in restoring functional patency to the vascular graft. Three attempts were unsuccessful; two of these three grafts were subsequently repaired surgically. Venous stenoses that extended far greater than 6 cm were not considered for PTA. We conclude that PTA is a technique of promise in the non-surgical salvage of failing PTFE grafts. PTA can prolong the useful life of PTFE vascular access grafts and can be performed on an outpatient basis, eliminating the hospitalization that is usually required for surgical revision.
自1984年以来，利用高压球囊导管进行的经皮腔内血管成形术（PTA）已被用作恢复聚四氟乙烯（PTFE，戈尔特斯）血液透析血管通路移植物通畅性的初始方法。通过瘘管造影检测到的17处狭窄病变接受了择期PTA。其中12处病变在血栓切除术后被检测到，5处病变是由于透析期间静脉压力升高而被检测到。14次PTA尝试在恢复血管移植物的功能通畅方面完全成功。3次尝试未成功；这3个移植物中的2个随后进行了手术修复。静脉狭窄延伸超过6 cm的情况不考虑进行PTA。我们得出结论，PTA是一种在挽救失败的PTFE移植物方面有前景的非手术技术。PTA可以延长PTFE血管通路移植物的使用寿命，并且可以在门诊进行，无需通常手术翻修所需的住院治疗。
