关键词: 内瘘血管狭窄, 腔内血管成型术, B超监测下

Abstract: Objective To determine whether percutaneous transluminal angioplasty (PTA) guided by ultrasound is a safe and effective method for treating arteriovenous fistula stenosis in hemdialysis patients. Methods The need for angioplasty intervention was determined by computed tomography angiography (CTA) and duplex ultrasound. Patients with the luminal narrowing ≥50% or the vascular diameter <2.5mm were referred to the treatment. The balloon was introduced to the lesion site through a guide wire under the guide of ultrasound. The balloon was then inflated by infusion of normal saline at the pressure increase rate of one atmosphere per 2 seconds until the disappearance of the stenosis. Results A total of 1,244 operations of PTA for 569 patients were performed in our hospital from Jun. 2009 to Dec. 2015. The technical and clinical success rates were 98%. The average vascular diameter was 2.094±0.599mm before the intervention, and was 3.916±0.720mm after the intervention (t=20.933, P＜0.001). Local and small amount of extravasation happened in 10 cases, and disappeared within a week after gentle pressure dressing. There was no vessel rupture and thrombosis due to the PTA manipulation. Conclusion Ultrasound guided PTA for the treatment of arteriovenous fistula stenosis has the advantage of no X-ray radiation, no contrast agent injection, and using relatively simple equipment. Ultrasound equipment is also available for vascular imaging and blood flow measurement. PTA under ultrasound guidance for arteriovenou fistula stenosis can be performed safely, simply and effectively, and is a valuable tool for the treatment of superficial vessel stenosis but not for the stenosis in central vein.

Key words: Anteriovenous fistula stenosis, Percutaneous transluminal angioplasty, Ultrasound guidance