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动脉静脉透析的内血管血栓切除术:一种可行的治疗方法?
Rui Filipe Nogueira1, Nuno Afonso Oliveira1, Emanuel Ferreira1
1Centro de Acessos Vasculares-Sanfil Medicina, Coimbra, Portugal.
概括
内血管手动血栓吸收是对血栓化动脉静脉血管接入的有效治疗方法,其成功率很高. 前臂囊实现了卓越的透度,支持它们的优先使用.
科学领域:
- 血管外科 血管外科
- 干预性病学 干预性病学
- 血管内治疗疗法 血管内疗法
背景情况:
- 动脉静脉血管接入血栓是血液透析患者的常见并发症.
- 目前的入口血栓瘤治疗方案包括手术和内血管方法,通透率相似.
- 血管内手动血栓吸收为挽救血栓接入提供了一种最少的侵入性选择.
研究的目的:
- 评估内血管手动血栓吸收治疗动脉静脉血管接入血栓的疗效和通透率.
- 为了比较动脉静脉囊和动脉静脉移植之间的内血管治疗结果.
- 根据动脉静脉的位置 (前臂与上臂) 来分析穿透率.
主要方法:
- 在2017年6月至2022年2月期间接受治疗的96名动脉静脉接入血栓患者的回顾性分析.
- 所有患者都接受了内血管手动血栓吸收.
- 收集的数据包括患者人口统计,并发病,临床数据和干预结果.
主要成果:
- 血管内血栓吸收的整体成功率为85.4%,再干预率为59.8%.
- 与动脉静脉囊相比,动脉静脉移植显示出更好的二次通透性 (92.4%与6个月的78.0%相比).
- 前臂抽显示出明显更好的初级通透性 (72.7%相比41.5%在6个月),辅助初级通透性 (81.8%相比55.8%在6个月),和较低的再干预率 (27.3%相比63.3%) 比上臂抽.
结论:
- 内血管手动血栓吸收是挽救血栓化动脉静脉血管通道的可行的替代方案.
- 前臂动脉静脉囊表现出优越的通透性,与上臂囊相比,需要更少的重新干预.
- 优先考虑前臂片的构建可能会改善长期的血管接入结果.
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