Clinical comparison of percutaneous transluminal angioplasty and surgical resection for Cimino-Brescia arteriovenous fistula stenosis in hemodialysis patients
10.16571/j.cnki.1008-8199.2017.12.017
- VernacularTitle:经皮腔内血管成形术与手术治疗血液透析患者自体动静脉内瘘狭窄的临床效果比较
- Author:
ting Yan YU
1
;
hui Zhan GAO
;
bing Liu ZHAO
;
juan Lei XIAO
;
bo Zhi ZHENG
;
zhang Run ZHU
;
ying Hong WANG
;
jun Xian L(U)
;
xi Da JI
Author Information
1. 南京医科大学附属南京明基医院肾脏内科
- Keywords:
Percutaneous transluminal angioplasty;
Arteriovenous fistula;
Stenosis;
Patency rate
- From:
Journal of Medical Postgraduates
2017;30(12):1305-1308
- CountryChina
- Language:Chinese
-
Abstract:
Objeetive As to the high incidence of arteriovenous fistula(AVF) stenosis,surgical operation will result in the exhaustion of vascular resources in patients,while percutaneous transluminal angioplasty(PTA) can maintain vascular resources for ostomy.However,there is still no clear definition between the choices of PTA and surgical resection.The aim of this study was to compare the efficacy of PTA and surgical resection followed by reconstruction for the treatment of arteriovenous fistula stenosis in order to find appropriate treatment.Methods Retrospective analysis had been done on 46 hemodialysis patients with arteriovenous fistula stenosis in Nanjing BenQ hospital from January 2015 to March 2017,which included 22 cases treated with PTA (PTA group) and 24 cases treated with surgical operation (operation group).Comparison was made in general clinical situation,patency rate at six months after surgery,over patency time and adverse reactions to surgery between the two groups.Results The number of stenoses in PTA group was bigger than that in operation group and the difference was of statistic significance (2.78±1.43 vs 1.67±0.71,P＜0.05).There was no significant difference in patency rate between the two groups (P =0.828).There were 57 venous stenoses in PTA group,among which 12 stenoses were anastomotic (21.05％) with 79.3％ average stenosis degree and 43 stenoses were at venous outflow tract of fistula (75.44％) with 84.26 average stenosis degree.In PTA group,3 patients had hematoma brachial puncture position and recovered by self-absorption without special treatment.In operation group,1 patient had mild blood oozing and recovered after treatment;4 patients recovered gradually from mild swelling on the back of the hand of the operation side.No difference was found in adverse reactions between two groups (P＞0.05).Conclusion PTA treatment is preferred for multiple stenoses(n ≥ 3),which ensures better preservation of vascular resources at a comparable patency rate.
