Silalahi Todung D A, Suwita Christopher S
Division of Cardiovascular, Department of Internal Medicine, Krida Wacana Christian University, Jakarta, Indonesia.
Department of Cardiology, Jakarta Heart Center Hospital, Jakarta, Indonesia.
Int J Angiol. 2021 Nov 22;32(1):66-70. doi: 10.1055/s-0041-1735207. eCollection 2023 Mar.
Arteriovenous fistula is the best permanent vascular access for hemodialysis (HD). However, in our country, HD catheter in jugular or subclavian vein is more commonly found because our patients prefer to hold HD until the complications are unbearable. The catheter increases risk of venous stenosis on site and in surrounding vessels, resulting in access loss. Percutaneous transluminal angioplasty (PTA), combined with stent deployment, can be utilized as main treatment for such stenosis in subclavian vein. This method dated back to two decades ago with high success rate. Nevertheless, reports or studies of angioplasty in total occlusion are scarce, mainly because of lower success rate and the need of smaller penetrating wire. We describe our experience in performing PTA and stent deployment using coronary wire to penetrate total occlusion in subclavian venous stenosis after vein cannulation. We hope that we can give an alternative technique to avoid surgery in such cases.
动静脉内瘘是血液透析（HD）的最佳永久性血管通路。然而，在我国，颈内静脉或锁骨下静脉的血液透析导管更为常见，因为我们的患者倾向于坚持进行血液透析，直到并发症难以忍受。该导管会增加局部及周围血管静脉狭窄的风险，导致通路丧失。经皮腔内血管成形术（PTA）联合支架置入可作为锁骨下静脉此类狭窄的主要治疗方法。这种方法可追溯到二十年前，成功率很高。然而，关于完全闭塞血管成形术的报道或研究很少，主要是因为成功率较低且需要更细的穿刺导丝。我们描述了在静脉插管后使用冠状动脉导丝穿透锁骨下静脉狭窄完全闭塞部位进行PTA和支架置入的经验。我们希望能提供一种替代技术，在此类病例中避免手术。
