Shindo Mitsutoshi, Ookawara Susumu, Kovarova Lucie, Morino Junki, Minato Saori, Ito Kiyonori, Malik Jan, Morishita Yoshiyuki
Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama-City, Saitama-ken 330-8503, Japan.
Third Department of Internal Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
Radiol Case Rep. 2020 Jul 3;15(9):1493-1495. doi: 10.1016/j.radcr.2020.05.072. eCollection 2020 Sep.
A 79-year-old woman who was on chronic hemodialysis due to diabetic nephropathy and had previously undergo surgery for radiocephalic arteriovenous fistula (AVF) in her right wrist needed percutaneous transluminal angioplasty (PTA) for stenosis at the juxta-anastomotic access site. After successful PTA, the systemic blood pressure decreased from 144/93 mm Hg to 117/67 mm Hg in response to the increase in AVF blood flow. Furthermore, the regional oxygen saturation (rSO) value in her dorsal hand decreased from 67.9% to 64.9% and, simultaneously, the cerebral rSO decreased from 63.6% to 60.1%. Our experience indicates that the PTA procedure may affect the rapid deterioration of systemic oxygenation, including that in the hand and brain, in association with the increase in the AVF blood flow and change in systemic circulation.
一名79岁女性因糖尿病肾病接受长期血液透析，此前曾因右腕桡动脉动静脉内瘘（AVF）接受手术，现因吻合口附近通路部位狭窄需要进行经皮腔内血管成形术（PTA）。PTA成功后，随着AVF血流量增加，全身血压从144/93 mmHg降至117/67 mmHg。此外，她手背的局部氧饱和度（rSO）值从67.9%降至64.9%，同时，脑部rSO从63.6%降至60.1%。我们的经验表明，PTA手术可能会随着AVF血流量增加和全身循环变化，影响包括手部和脑部在内的全身氧合迅速恶化。
