Zhejiang Da Xue Xue Bao Yi Xue Ban. 2021 Dec 25;50(6):770-776. doi: 10.3724/zdxbyxb-2021-0121.
To investigate the feasibility, methods and efficacy of ultrasound-guided nitinol stent implantation for the treatment of early recurrent stenosis of arteriovenous fistula (AVF). Thirty patients with early recurrent stenosis after percutaneous transluminal angioplasty (PTA) who received ultrasound-guided nitinol stent implantation in Sir Run Run Shaw Hospital of Zhejiang University from April 2018 to July 2020 were followed up. The imaging features of the procedure and the interventional devices were observed under ultrasonography. The technical success rate and the clinical success rate as well as the incidence of complication were assessed. The post-interventional primary patency rates of access circuit, primary patency rates of target lesion and secondary patency rates were estimated. Ultrasonography was able to demonstrate the operation process and the interventional devices clearly. The technical and clinical success rates were both 100.0%. Eight patients had in-stent restenosis, which were treated by PTA. The post-interventional primary patency rates of the access circuit after 3, 6, 9 and were 91.3%, 86.2%, 86.2% and 64.2%, respectively; the post-interventional primary patency rates of target lesion were 100.0%, 100.0%, 86.4% and 69.3%, respectively; the post-interventional secondary patency rates were 100.0%, 100.0%, 100.0% and 94.4%, respectively. Compared with previous PTA in these cases, stent implantation had a higher post-interventional primary patency rates of target lesion and a lower cost-effectiveness (both <0.05). No other complications such as vascular rupture, pseudohemangioma, stent infection, stent displacement and stent exposure were observed during the follow-up. Ultrasonography can accurately guide the nitinol stent implantation in AVF, and the technique is feasible in treatment for the early recurrent stenosis after PTA with good short- and medium-term efficacy.
探讨超声引导下镍钛合金支架植入治疗动静脉瘘（AVF）早期再狭窄的可行性、方法和疗效。
回顾性分析 2018 年 4 月至 2020 年 7 月在浙江大学医学院附属邵逸夫医院接受超声引导下镍钛合金支架植入术治疗的 30 例经皮腔内血管成形术（PTA）后早期再狭窄的患者资料。观察超声引导下手术过程和介入器械。评估技术成功率、临床成功率和并发症发生率。评估术后通路的一期通畅率、靶病变的一期通畅率和二期通畅率。
超声能清晰显示手术过程和介入器械。技术成功率和临床成功率均为 100.0%。8 例支架内再狭窄患者行 PTA 治疗。术后 3、6、9 个月，通路的一期通畅率分别为 91.3%、86.2%、86.2%和 64.2%；靶病变的一期通畅率分别为 100.0%、100.0%、86.4%和 69.3%；二期通畅率分别为 100.0%、100.0%、100.0%和 94.4%。与既往 PTA 比较，支架植入术治疗后靶病变的一期通畅率更高，而成本效益比更低（均<0.05）。随访期间未发生血管破裂、假性血管瘤、支架感染、支架移位和支架外露等其他并发症。
超声可准确引导 AVF 镍钛合金支架植入术，该技术治疗 PTA 后早期再狭窄是可行的，具有良好的短期和中期疗效。
