Nayak-Rao Shobhana, Ramanna Bhanushree, Subramanyam K, Shenoy M Pradeep, Kamath Janardhan
Department of Nephrology, KS Hegde Medical Academy, Derlakatte, Karnataka, India.
Department of Cardiology, KS. Hegde Medical Academy, Mangalore, Karnataka, India.
Indian J Nephrol. 2020 Sep-Oct;30(5):337-341. doi: 10.4103/ijn.IJN_343_19. Epub 2020 Aug 27.
Central venous stenosis (CVS) refers to a significant stenosis of a large intrathoracic vein, such as the subclavian, brachiocephalic, or the superior vena cava (hemodialysis, HD). Percutaneous transluminal angioplasty (PTA) with or without stent placement has been the recommended as the preferred approach to CVS. A total of 10 consecutive HD patients with documented CVS over a 2-year time period from April 2017-April 2019 underwent percutaneous angioplasty and stent insertions under sedation. The procedure was performed by the interventional cardiologist in the institute. One patient underwent only PTA, whereas nine (90%) had PTA with primary stent insertion. Primary patency was 90% at 3 months, 80% at 6 months while at 12 months, it was 70% and remained at 70% at 24 months. We did not find any association between age, gender, diabetic status, dialysis vintage, or previous catheter infection with procedural patency. Central venous stenosis can be treated successfully with percutaneous angioplasty and primary stenting. Despite advances, prevention of CVS should be the primary approach.
中心静脉狭窄（CVS）是指胸腔内大静脉，如锁骨下静脉、头臂静脉或上腔静脉（血液透析，HD）的严重狭窄。经皮腔内血管成形术（PTA）无论是否置入支架，都已被推荐为治疗CVS的首选方法。在2017年4月至2019年4月的两年时间里，共有10例连续的有记录的HD患者患有CVS，在镇静状态下接受了经皮血管成形术和支架置入术。该手术由该机构的介入心脏病专家进行。1例患者仅接受了PTA，而9例（90%）接受了PTA并同时置入了初级支架。3个月时的初级通畅率为90%，6个月时为80%，12个月时为70%，24个月时仍为70%。我们没有发现年龄、性别、糖尿病状态、透析时间或既往导管感染与手术通畅率之间存在任何关联。经皮血管成形术和初级支架置入术可以成功治疗中心静脉狭窄。尽管有进展，但预防CVS仍应是主要方法。
