透析通路维护:单纯球囊血管成形术。
Dialysis Access Maintenance: Plain Balloon Angioplasty.
机构信息
Department of Interventional Radiology, St George's University Hospitals NHS Foundation Trust, London, UK.
Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK.
出版信息
Cardiovasc Intervent Radiol. 2023 Sep;46(9):1136-1143. doi: 10.1007/s00270-023-03441-x. Epub 2023 May 8.
Plain balloon angioplasty remains the first-line treatment for dialysis access stenosis. This chapter reviews the outcomes of plain balloon angioplasty from cohort studies and comparative studies. Angioplasty outcomes are more favourable in arteriovenous fistulae (AVF) compared to arteriovenous grafts (AVG) with primary patency at 6 months ranging from 42-63% compared to 27-61%, respectively, and improved for forearm fistulae compared with upper arm fistulae. Higher pressures are required to treat stenoses in AVFs compared to AVGs. Outcomes are worse in more severe stenoses, increased patient age, previous interventions and fistulae that develop early stenoses. Major complication rates following angioplasty in dialysis access are between 3 and 5%. Repeat treatments and the use of adjuncts such as drug-coated balloons and stents can prolong the patency of dialysis access. Level of Evidence No level of evidence (Review paper).
单纯球囊血管成形术仍然是透析通路狭窄的一线治疗方法。本章回顾了来自队列研究和对比研究的单纯球囊血管成形术的结果。与动静脉移植物(AVG)相比,动静脉瘘(AVF)的血管成形术结果更有利,6 个月时的原发性通畅率分别为 42-63%和 27-61%,前臂瘘比上臂瘘更好。与 AVG 相比,治疗 AVF 狭窄需要更高的压力。狭窄程度越严重、患者年龄越大、既往介入治疗以及早期出现狭窄的瘘管,结果越差。透析通路血管成形术后的主要并发症发生率为 3%至 5%。重复治疗和使用药物涂层球囊和支架等辅助手段可以延长透析通路的通畅率。证据等级 无证据等级(综述论文)。
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