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经隧道式中心静脉导管致上腔静脉完全闭塞的血管内治疗:贯穿技术

Endovascular treatments of tunneled central venous catheter-induced superior vena cava complete occlusion via through-and-through technique.

作者信息

Li Nan, Zeng Ni, Chen Bin, Huang Yonghui

机构信息

Department of Interventional Radiology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Research Center of Medical Sciences, Guangdong General Hospital, School of Medicine, South China University of Technology, Guangzhou, China.

出版信息

Hemodial Int. 2021 Jan;25(1):35-42. doi: 10.1111/hdi.12889. Epub 2020 Oct 11.

Abstract

BACKGROUND

Superior vena cava occlusion (SVCO) induced by tunneled central venous catheter (tCVC) is an uncommon but challenging complication of hemodialysis patients. The aim of this study was to access the efficacy, safety, and patency of stents in tCVC-related SVCO via through-and-through technique.

METHOD

We retrospectively identified seven patients with benign SVCO secondary to tCVC treated with endovascular approaches successfully between 1 March 2013 and 31 October 2019. Patients' demographic data, clinical signs and symptoms, and imaging data were followed up and recorded.

RESULTS

Technical success was achieved in all cases. All the patients were performed with percutaneous transcatheter angioplasty (PTA) and subsequently stent placement via the through-and-through technique. During follow-up, four patients underwent secondary interventions, including PTA and/or stent placement. The primary patency after 3, 6, 9 and 12 months was 100%, 100%, 86% and 86%, and secondary patency after 12 months was 100%. No procedure-related deaths occurred.

CONCLUSIONS

Endovascular management of SVCO is a safe and effective approach. CT examination can provide a direction for endovascular treatment and periodic surveillance.

摘要

背景

隧道式中心静脉导管(tCVC)所致上腔静脉阻塞(SVCO)是血液透析患者中一种罕见但具有挑战性的并发症。本研究旨在通过贯穿技术评估支架置入术治疗tCVC相关SVCO的疗效、安全性和通畅性。

方法

我们回顾性分析了2013年3月1日至2019年10月31日期间成功接受血管内介入治疗的7例继发于tCVC的良性SVCO患者。对患者的人口统计学数据、临床症状和体征以及影像学数据进行随访并记录。

结果

所有病例均取得技术成功。所有患者均接受了经皮经导管血管成形术(PTA),随后通过贯穿技术置入支架。随访期间,4例患者接受了二次干预,包括PTA和/或支架置入。3、6、9和12个月时的原发性通畅率分别为100%、100%、86%和86%,12个月时的继发性通畅率为100%。未发生与手术相关的死亡。

结论

血管内治疗SVCO是一种安全有效的方法。CT检查可为血管内治疗和定期监测提供指导。

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