Department of Nephrology, Chutoen General Medical Center, Kakegawa, Shizuoka, Japan.
J Vasc Access. 2024 Sep;25(5):1682-1685. doi: 10.1177/11297298231190253. Epub 2023 Aug 14.
Arteriovenous fistulas (AVFs) are frequently used for hemodialysis access, but approximately 15%-20% of AVFs fail to mature within 3 months of their creation. Vascular access interventional therapy (VAIVT) is typically performed for treating an immature AVF. However, it should be performed 4-6 weeks or later after AVF creation. Here, we present a case in which VAIVT effectively addressed AVF occlusion that occurred only 9 days after its creation. The patient was an 82-year-old woman with chronic kidney disease who underwent surgery to create a left radiocephalic AVF for hemodialysis. Nine days postoperatively, disappearance of the AVF sound prompted an angiography, revealing thrombosis near the AVF anastomosis. VAIVT successfully restored blood flow, resulting in AVF maturation, and with no thrombosis or flow dysfunction at 21 months after VAIVT. To the best of our knowledge, this case presents the earliest successful intervention for an occluded AVF.
动静脉瘘(AVF)常用于血液透析通路,但约 15%-20%的 AVF 在创建后 3 个月内无法成熟。血管通路介入治疗(VAIVT)通常用于治疗未成熟的 AVF。然而,它应该在 AVF 创建后 4-6 周或更晚进行。在这里,我们报告了一例仅在创建后 9 天就发生的 AVF 闭塞的病例,通过 VAIVT 有效解决。该患者为 82 岁女性,患有慢性肾脏病,接受手术在左侧头桡动脉创建用于血液透析的 AVF。术后 9 天,AVF 声音消失促使进行血管造影,显示 AVF 吻合口附近有血栓形成。VAIVT 成功恢复了血流,导致 AVF 成熟,并且在 VAIVT 后 21 个月时没有血栓形成或血流功能障碍。据我们所知,这是首例成功治疗闭塞性 AVF 的病例。