OBJECTIVE: We wanted to report our experience of metallic stent placement after insufficient balloon dilation in graft hemodialysis patients. MATERIALS AND METHODS: Twenty-three patients (13 loop grafts in the forearm and 10 straight grafts in the upper arm) underwent metallic stent placement due to insufficient flow after urokinase thrombolysis and balloon dilation. The indications for metallic stent deployment included 1) recoil and/or kinked venous stenosis in 21 patients (venous anastomosis: 17 patients, peripheral outflow vein: four patients); and 2) major vascular rupture in two patients. Metallic stents 8-10mm in diameter and 40-80 mm in length were used. Of them, eight stents were deployed across the elbow crease. Access patency was determined by clinical follow-up and the overall rates were calculated by Kaplan-Meier survival analysis. RESULTS: No procedure-related complications (stent fracture or central migration) were encountered except for a delayed Wallstent shortening/migration at the venous anastomosis, which resulted in early access failure. The overall primary and secondary patency rates (+/- standard error) of all the vascular accesses in our 23 patients at 3, 6, 12 and 24 months were 69% +/- 9 and 88% +/- 6, 41% +/- 10 and 88% +/- 6, 30% +/- 10 and 77% +/- 10, and 12% +/- 8 and 61% +/- 13, respectively. For the forearm and upper-arm grafts, the primary and secondary patency rates were 51% +/- 16 and 86% +/- 13 vs 45% +/- 15 and 73%+/-13 at 6 months, and 25% +/- 15 and 71% +/- 17 vs 23% +/- 17 and 73% +/- 13 at 12 months (p = .346 and .224), respectively. CONCLUSION: Metallic stent placement is a safe and effective means for treating peripheral venous lesions in dialysis graft patients after insufficient balloon dilation. No statistically difference in the patency rates between the forearm and upper-arm patient groups was seen.
Vascular Patency ; Treatment Failure ; Stents ; Renal Dialysis ; Polytetrafluoroethylene ; Middle Aged ; Metals ; Male ; Humans ; Graft Occlusion, Vascular/*therapy ; Forearm ; Female ; *Arteriovenous Shunt, Surgical ; *Angioplasty, Balloon ; Aged, 80 and over ; Aged

Objective To explore preoperative psychological experience in patients with the tibia and fibula fracture that treated with 3D printing individualized external fixation, and provide theoretical basis for the medical treatment and care. Methods From December 2013 to November 2015, sevenpatentstreated with 3D printing individualized external fixation in Xi′an Honghui Hospital, Xi′an Jiaotong University Health Science Center were selected as the interview object. This qualitative study was completed by phenomenon research methods, and combined with a variety of forms of interview.Colaizzi content analysis method was used to analyze the contents of collected data, and sort and refine the theme. Results Four effective subjects were extracted about preoperative psychological experience in patients with the tibia and fibula fracture treated with 3D printing individualized external fixation, in turn were uncertainty effect of surgery; high expectations, but the lack of knowledge about 3D printing, economic burden of disease; longing for family support system. Conclusions Medical staff should pay attention to preoperative psychological feelings in patients with the tibia and fibula fracture treated with 3D printing individualized external fixation, deal with a targeted psychological nursing and coping style, provide an effective nursing intervention and health education. further more optimize the 3D external fixation cost,and incorporate the 3D external fixation into the social medical insurance category.