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目的在国内初步报道VascuTrak~(TM)球囊导管治疗血液透析患者自体动静脉内瘘(AVF)非血栓性顽固狭窄闭塞的经验和体会。方法采用近期在中国上市的新型经皮腔内血管成形术球囊导管——VascuTrak~(TM)球囊导管治疗14例AVF顽固性狭窄闭塞患者,观察分析临床治疗效果,如技术成功率、术中局部疼痛、残余狭窄及并发症发生率等。结果全部14例患者AVF狭窄闭塞均获即时开通,技术成功率100%。1~6 atm压力下VascuTrak~(TM)球囊全部获得充分扩张,其中1次成功12例(85.7%),2次成功2例(14.3%);腕部无疼痛10例,轻度疼痛4例,难以忍受的剧烈疼痛0例。术后彩色超声复查AVF通畅,残存狭窄>30%患者0例。术中术后未发生血管夹层、痉挛及急性血栓形成,1例术后出现肱动脉假性动脉瘤,手术修补重建后恢复,与VascuTrak~(TM)球囊治疗无关。结论 VascuTrak~(TM)球囊治疗AVF失效安全有效,近期疗效良好,中远期疗效及通畅率有待进一步随访观察。
Objective To report initially the experience and experience of VascuTrak ™ balloon catheter in the treatment of non-thrombotic occlusive non-thrombotic occlusion of autologous arteriovenous fistula (AVF) in hemodialysis patients. Methods A new type of percutaneous transluminal angioplasty balloon catheter, VascuTrak ™ balloon catheter, recently introduced in China was used to treat 14 patients with refractory occlusive stenosis of AVF. Clinical therapeutic effects were observed and analyzed, such as technical success rate, In the local pain, residual stenosis and complications such as incidence. Results All 14 cases of patients with AVF stenosis were immediately opened, the technical success rate of 100%. VascuTrak ~ (TM) balloon was fully expanded at 1 ~ 6 atm pressure, of which 12 cases (85.7%) were successful in 1 case and 2 cases (14.3%) were successful in 2 cases. There were 10 cases without pain in wrist, 4 cases with mild pain Cases, unbearable severe pain in 0 cases. Postoperative color ultrasound review AVF patency, residual stenosis> 30% of patients in 0 cases. There was no postoperative vascular dissection, spasm and acute thrombosis. One patient had false brachial artery aneurysm and recovered after surgical repair and reconstruction, which was not related to VascuTrak TM balloon therapy. Conclusions VascuTrak ™ balloon therapy is safe and effective in the treatment of AVF failure. The short-term curative effect is good. The long-term curative effect and patency rate need further follow-up.