Himmelfarb J, Saad T
Division of Nephrology, Maine Medical Center, Portland 04102, USA.
Curr Opin Nephrol Hypertens. 1996 Nov;5(6):485-91. doi: 10.1097/00041552-199611000-00005.
Vascular access complications remain a leading cause of morbidity and hospitalization in patients on chronic maintenance hemodialysis. Although arteriovenous fistulas remain the dialysis access of choice, an increasing percentage of patients are dialyzed using synthetic grafts or permanent catheters. The most frequent vascular access complications are the development of stenosis and of thrombosis. In recent years, increasing attention is being paid to screening techniques designed to detect vascular access stenosis prior to thrombosis. Aggressive screening techniques coupled with interventional procedures such as angioplasty may reduce the incidence of graft thrombosis. Once thrombosis has occurred, mechanical or pharmacomechanical thrombolysis in conjunction with angioplasty may be an effective alternative to surgical thrombectomy.
血管通路并发症仍然是慢性维持性血液透析患者发病和住院的主要原因。尽管动静脉内瘘仍然是透析通路的首选，但越来越多的患者使用人造血管或永久性导管进行透析。最常见的血管通路并发症是狭窄和血栓形成。近年来，人们越来越关注旨在在血栓形成之前检测血管通路狭窄的筛查技术。积极的筛查技术与诸如血管成形术等介入程序相结合，可能会降低移植物血栓形成的发生率。一旦发生血栓形成，机械或药物机械溶栓结合血管成形术可能是手术取栓的有效替代方法。
