[1]孙 浩,赵 霞,王 哲,等.支架植入治疗血液透析相关中心静脉病变效果及影响通畅率的因素[J].介入放射学杂志,2023,32(08):741-745.
 SUN Hao,ZHAO Xia,WANG Zhe,et al.The efficacy of stent implantation for hemodialysis-related central venous diseases and the risk factors affecting the patency rate[J].journal interventional radiology,2023,32(08):741-745.
点击复制

支架植入治疗血液透析相关中心静脉病变效果及影响通畅率的因素()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
32
期数:
2023年08
页码:
741-745
栏目:
血管介入
出版日期:
2023-08-29

文章信息/Info

Title:
The efficacy of stent implantation for hemodialysis-related central venous diseases and the risk factors affecting the patency rate
作者:
孙 浩 赵 霞 王 哲 刘杨东 傅麒宁 赵 渝
Author(s):
SUN Hao ZHAO Xia WANG Zhe LIU Yangdong FU Qining ZHAO Yu.
Department of General Surgery, Jinshan Hospital of First Affiliated Hospital of Chongqing Medical University, Chongqing 401122, China
关键词:
【关键词】 中心静脉病变 覆膜支架 裸支架 通畅率
文献标志码:
A
摘要:
【摘要】 目的 探讨支架植入治疗血液透析(血透)相关中心静脉病变(CVD)的效果,分析影响通畅率的因素。方法 纳入2015年12月至2020年3月重庆医科大学附属第一医院金山医院收治的因血透相关CVD接受腔内支架植入术患者,收集一般资料、手术信息、术后随访情况,分析影响通畅率的因素。 结果 共纳入89例患者,根据支架类型分为覆膜支架组(n=70)和裸支架组(n=19),覆膜支架又分为Viabahn(n=17)和Fluency(n=53)。术后3、6、12、24个月初级通畅率和次级通畅率在覆膜支架组分别为97.1%、88.6%、71.4%、55.7%和100%、98.6%、94.3%、85.7%,裸支架组分别为84.2%、57.9%、21.1%、15.8%和100%、100%、84.2%、47.4%,两组间比较差异均有统计学意义(均P<0.01)。Viabahn支架初级通畅率优于Fluency支架(P=0.044),次级通畅率差异无统计学意义(P=0.061)。多因素分析显示,覆膜支架长度与初级通畅率相关(OR=2.162,95%CI=1.248~5.764,P=0.048),支架长度越长初次通畅率越低。结论 支架植入治疗血透相关CVD安全有效。覆膜支架通畅率优于裸支架,Viabahn通畅率优于Fluency。支架长度是影响覆膜支架通畅率的危险因素。

参考文献/References:

[1] Krishna VN, Eason JB, Allon M. Central venous occlusion in the hemodialysis patient[J]. Am J Kidney Dis, 2016, 68: 803- 807.
[2] Modabber M, Kundu S. Central venous disease in hemodialysis patients: an update[J]. Cardiovasc Intervent Radiol, 2013, 36: 898- 903.
[3] 金其庄,王玉柱,叶朝阳,等.中国血液透析用血管通路专家共识[J]. 中国血液净化, 2019, 18:365- 381.
[4] 周春泽,侯昌龙,兰 雷,等. 经皮腔内血管成形术治疗血液透析患者肿胀手综合征[J]. 介入放射学杂志, 2017, 26:5.
[5] Macrae JM, Ahmed A, Johnson N, et al. Central vein stenosis:a common problem in patients on hemodialysis[J]. ASAIO J, 2005, 51: 77- 81.
[6] Ma W,Zhao Z,Fu Q,et al. Comparison of management for central venous stenosis with or without previous catheter placement[J]. Front Neurol,2021,12:703286.
[7] Poinen K,Quinn RR,Clarke A,et al. Complications from tunneled hemodialysis catheters:a Canadian observational cohort study[J]. Am J Kidney Dis, 2019, 73: 467- 475.
[8] Gür S, Oguzkurt L, Gedikolu M. Central venous occlusion in hemodialysis access: comparison between percutaneous transluminal angioplasty alone and nitinol or stainless- steel stent placement[J]. Diagn Interv Imaging, 2019, 100: 485- 492.
[9] 石勇胜,傅麒宁,胡良柱,等.经皮腔内球囊扩张术及支架置入术治疗血液透析患者中心静脉狭窄长期临床效果分析[J].中国血液净化, 2016, 15:569- 572.
[10] Ronald J,Davis B,Guevara CJ,et al. Treatment of central venous in- stent restenosis with repeat stent deployment in hemodialysis patients[J]. J Vasc Access, 2017, 18: 214- 219.
[11] Boutrous ML, Alvarez AC, Okoye OT, et al. Stent- graft length is associated with decreased patency in treatment of central venous stenosis in hemodialysis patients[J]. Ann Vasc Surg, 2019, 59: 225- 230.
[12] Chen B, Lin R, Dai H, et al. One- year outcomes and predictive factors for primary patency after stent placement for treatment of central venous occlusive disease in hemodialysis patients[J]. Ther Adv Chronic Dis, 2022: 13: 20406223211063039.
[13] Quaretti P, Galli F, Moramarco LP, et al. Stent grafts provided superior primary patency for central venous stenosis treatment in comparison with angioplasty and bare metal stent: a retrospective single center study on 70 hemodialysis patients[J]. Vasc Endo-vascular Surg, 2016, 50: 221- 230.

相似文献/References:

[1]廖登辉,叶财盛,李松奇,等.覆膜支架治疗12例假性动脉瘤的体会[J].介入放射学杂志,2012,(05):374.
 ,,et al. Treatment of pseudoaneurysms with stentgraft: preliminary experience in 12 cases[J].journal interventional radiology,2012,(08):374.
[2]周 兵,李明华,王建波,等.覆膜支架置入封堵治疗后动脉瘤形态学变化的实验研究[J].介入放射学杂志,2011,(02):131.
 ZHOU Bing,LI Ming-hua,WANG Jian-bo,et al.The morphologic changes of aneurysms after isolated by covered stent implantation: an experimental study[J].journal interventional radiology,2011,(08):131.
[3]刘志兵,杨代华. 枪弹伤导致双下肢多发动静脉瘘一例[J].介入放射学杂志,2012,(03):210.
 .Multiple arteriovenous fistulas in both lower extremities caused by gunshot wounds: report of one case [J].journal interventional radiology,2012,(08):210.
[4]周 政,邹建伟,朱晓黎,等.全覆膜支架治疗不同原因食管瘘的有效性及安全性分析[J].介入放射学杂志,2011,(05):403.
 ZHOU Zheng,ZOU Jian-wei,ZHU Xiao-li,et al.Covered stent placement for the treatment of esophageal fistulae caused by different disorders: an analysis of its effectiveness and safety[J].journal interventional radiology,2011,(08):403.
[5]陈亮,顾建平,楼文胜,等.覆膜支架腔内隔绝术治疗外周动脉瘤[J].介入放射学杂志,2012,(02):107.
 CHEN Liang,GU Jian-ping,LOU Wen-sheng,et al.Endovascular covered stent-graft exclusion of peripheral aneurysms[J].journal interventional radiology,2012,(08):107.
[6]朱守艳,曾俊仁,徐 松,等. 暂时性覆膜支架治疗贲门失弛缓症47例回顾性分析[J].介入放射学杂志,2013,(06):507.
 ZHU Shou? yan,ZENG Jun? ren,XU Song,et al. The implantation of temporary covered?蛳 stent for the treatment of achalasia of cardia: a retrospective analysis[J].journal interventional radiology,2013,(08):507.
[7]赵剑波,陈 勇,何晓峰,等.聚四氟乙烯覆膜支架经颈静脉肝内门腔 分流术后分流道再狭窄及影响因素分析[J].介入放射学杂志,2013,(08):629.
 ZHAO Jian? bo,CHEN Yong,HE Xiao? feng,et al. Restenosis of the transjugular intrahepatic portosystemic shunt using stent covered with polytetrafluoroethylene and the analysis of its affecting factors[J].journal interventional radiology,2013,(08):629.
[8]熊 斌,梁惠民,郑传胜,等. 覆膜支架在外周动脉瘤及动脉夹层治疗中的应用[J].介入放射学杂志,2013,(01):31.
 XIONG Bin,LIANG Hui? min,ZHENG Chuan? sheng,et al. The application of covered stent implantation in the treatment of peripheral aneurysm and arterial dissection[J].journal interventional radiology,2013,(08):31.
[9]管生,金洁,李明省,等.覆膜支架植入术治疗肾动脉及肾移植术后假性动脉瘤[J].介入放射学杂志,2013,(07):545.
 GUAN Sheng,JIN Jie,LI Ming? xing,et al.Endovascular covered stenting for the treatment of renal pseudoaneurysm after renal transplantation[J].journal interventional radiology,2013,(08):545.
[10]闫 磊,施万印,朱悦琦,等.双Willis覆膜支架在犬颈动脉梭形动脉瘤模型的初步应用[J].介入放射学杂志,2013,(09):709.
 YAN Lei,SHI Wan? yin,ZHU Yue? qi,et al. Initial application of dual Willis covered stent in treating carotid fusiform aneurysms in canine models[J].journal interventional radiology,2013,(08):709.

备注/Memo

备注/Memo:
(收稿日期:2022- 06- 23)
(本文编辑:边 佶)
更新日期/Last Update: 2023-08-29