在胸口使用Viatorr支架,以保持血液透析接入功能
Mohammad Ghasemi-Rad1, Lauren Do2, Michael Collard3
1Department of Radiology, Section of Vascular and Interventional Radiology, Baylor College of Medicine, Houston, TX, USA.
Vascular and endovascular surgery
|June 13, 2023
概括
在血液透析患者中,Viatorr支架移植有效地治疗胸部出口静脉静脉封闭性疾病,没有表现出结构性故障. 这为由这些具有挑战性的病变引起的透析接入功能障碍提供了可行的解决方案.
科学领域:
- 血管外科 血管外科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 干预性放射学 干预性放射学
背景情况:
- 胸腔出口静脉狭性疾病影响高达30%的血液透析患者,导致手臂胀和通道功能障碍.
- 传统的气球血管整形由于胸部出口区域的硬化肌肉骨压缩而具有有限的疗效.
研究的目的:
- 评估使用戈尔·维亚托尔TIPS内膜假体 (维亚托尔支架移植) 来挽救中静脉狭性疾病患者的血液透析接入的结果.
- 评估Viatorr支架移植在胸部输出区域的安全性和有效性.
主要方法:
- 对血液透析患者具有上肢动脉静脉或移植的患者的回顾性图表审查.
- 纳入标准:Viatorr在中央静脉 (关节下/脑) 中的支架放置,以及可用的随访数据.
- 研究的重点是由于中央静脉病变导致透析接入功能障碍的患者.
主要成果:
- 九名患者符合纳入标准;干预措施是针对耐火性病变或血液动力学上显著的病变,这些病变对单独的血管造形术没有反应.
- 初级通透率在36至442天之间 (几何平均值为156.6天).
- 在随访期间,在成像上没有观察到支架骨折,最大的随访时间为2912天 (平均837天).
结论:
- 在这个血液透析患者队伍中,Viatorr支架移植没有显示出任何结构性故障 (骨折) 胸部出口静脉病变.
- 支架移植似乎是一种安全且潜在的有效选择,用于管理在这个具有挑战性的解剖位置的血液透析接入功能障碍.
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