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紫杉醇洗脱球囊与普通球囊血管成形术治疗血液透析患者中心静脉狭窄的功能通畅率比较:一项个体内比较研究。

Comparison of functional patency rates between paclitaxel-eluting versus plain balloon angioplasty in hemodialysis patients with central venous stenosis: An intra-individual comparison study.

机构信息

Department of Radiology, Istanbul Training and Research Hospital, Istanbul, Turkey.

Department of Radiology, Istanbul Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.

出版信息

Ther Apher Dial. 2022 Feb;26(1):185-190. doi: 10.1111/1744-9987.13662. Epub 2021 May 8.

Abstract

Central venous stenosis (CVS) is usually a late-diagnosed clinical entity that is common in hemodialysis patients. It causes various problems ranging from hemodialysis difficulty to loss of the arterio-venous (A-V) fistula. In the present study, we aimed to determine the effect of drug eluting balloon while excluding the influence of other variable factors by evaluating the same individuals with plain and paclitaxel-eluting balloons. This research was a prospective study of 18 symptomatic hemodialysis patients (age 50.9 ± 14.0 years, range 32-72 years; 11 male, 7 female) with CVS who underwent treatment by plain balloon angioplasty (PBA) and paclitaxel-eluting balloon angioplasty (PEBA) in our hospital from January 2016 to June 2017. First, third and sixth month central vein patency rates were compared. The median patency rates of central veins were 109.0 (range: 10-324) days after PBA and 238.5 (range: 157-501) days after PEBA (p < 0.001). There was no statistically significant difference between PBA and PEBA angioplasty in one-month patency (p ˃ 0.05). By contrast, a statistically significant difference was found between 3- and 6-month patency rates (p = 0.031 and p ˂ 0.001, respectively). Kaplan-Meier analysis revealed that the primary cumulative patency rate of PEBA was significantly longer than that of PBA (p ˂ 0.001). In this prospective study, PEBA patency is superior to PBA patency in the treatment of CVS in dialysis patients.

摘要

中心静脉狭窄(CVS)通常是一种晚期诊断的临床实体,在血液透析患者中很常见。它会导致各种问题,从血液透析困难到动静脉(A-V)瘘失。在本研究中,我们旨在通过评估使用普通球囊和紫杉醇洗脱球囊的同一患者,来确定药物洗脱球囊的效果,同时排除其他可变因素的影响。这项研究是对 2016 年 1 月至 2017 年 6 月在我院接受普通球囊血管成形术(PBA)和紫杉醇洗脱球囊血管成形术(PEBA)治疗的 18 例有症状的 CVS 血液透析患者(年龄 50.9±14.0 岁,范围 32-72 岁;男性 11 例,女性 7 例)进行的前瞻性研究。首先比较了第 1、3 和 6 个月的中心静脉通畅率。PBA 后中心静脉通畅率的中位数为 109.0(范围:10-324)天,PEBA 后为 238.5(范围:157-501)天(p<0.001)。PBA 和 PEBA 血管成形术在 1 个月通畅率方面无统计学差异(p>0.05)。相比之下,3 个月和 6 个月的通畅率有统计学差异(p=0.031 和 p<0.001)。Kaplan-Meier 分析显示,PEBA 的原发性累积通畅率明显长于 PBA(p<0.001)。在这项前瞻性研究中,PEBA 的通畅率在治疗透析患者 CVS 方面优于 PBA。

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