Settmacher U, Bürger K, Scholz H
Klinik für Gefässchirurgie, Humboldt Universität zu Berlin.
Zentralbl Chir. 1995;120(12):969-73.
Central av-shunts are indicated in patients who underwent multiple operations for dialysis access on the extremities or became periphero-vascular inoperable due to local infections. Between 1982 and 9/1994 116 patients had been operated. 71 patients obtained a subclavio-subclavial shunt, 13 patients a subclavio-jugular shunt and 32 patients a femoro-femoral shunt. As acute postoperative complication we found in seven patients an early thrombosis 2 to 6 days after operation, which could be thrombectomized unproblematically. Two patients after subclavio-subclavial shunt operation and 3 patients after femoro-femoral shunt acquired an infection of the prosthesis, which made the removal of the prosthesis necessary. In one patient with carcinoma a ligation of the av-shunt was done because of an extreme venous congestion due to a benign stenosis of the iliacal vein. Late thromboses were found in 15 patients. These occlusions were thrombectomized after anticoagulation or in case of complete occlusion of the collecting vein were treated by an extension of the prosthesis to another central vein. 35 patients died 15 days to 9 years (mean 6.4 years) after operation. It can be concluded that central av-shunts show a stable long-term function.
对于那些因肢体动静脉内瘘多次手术或因局部感染导致周围血管无法手术的患者，可考虑行中心动静脉分流术。1982年至1994年9月期间，116例患者接受了手术。71例患者行锁骨下-锁骨下分流术，13例患者行锁骨下-颈内静脉分流术，32例患者行股-股分流术。作为术后急性并发症，我们发现7例患者在术后2至6天出现早期血栓形成，可顺利进行血栓切除术。2例锁骨下-锁骨下分流术患者和3例股-股分流术患者发生了人工血管感染，因此有必要取出人工血管。1例癌症患者因髂静脉良性狭窄导致严重静脉淤血，对其动静脉分流进行了结扎。15例患者出现晚期血栓形成。这些阻塞在抗凝后进行血栓切除术，或在收集静脉完全阻塞的情况下，通过将人工血管延伸至另一中心静脉进行治疗。35例患者在术后15天至9年（平均6.4年）死亡。可以得出结论，中心动静脉分流术具有稳定的长期功能。
