关键词: 中心静脉闭塞, 牵张导丝技术, 透析

Abstract: Objective  To evaluate the feasibility and application value of the through and through technique in the treatment of central venous occlusion in hemodialysis patients.  Methods A retrospective analysis was conducted on 17 hemodialysis patients with central venous occlusion and undergoing vascular intervention surgery at the hospital from January 2020 to June 2023. Sharp recanalization technique or " needle-wire " technique was used to establish a traction wire pathway, followed by balloon dilation or balloon dilation combined with stent implantation. Surgical success rate, incidence of complications, and postoperative patency rate were recorded.  Results  Among the 17 patients, one patient experienced vessel perforation during wire recanalization, resulting in surgical failure, while the remaining 16 cases achieved surgical success with a success rate of 94.12%. There were no bleeding, mediastinal hematoma, cardiac tamponade, or central venous rupture during the manipulations, and no surgical-related deaths occurred. All 16 patients who had successful surgery were able to undergo normal hemodialysis, and the swelling in the upper limbs and face significantly subsided. The follow-up period ranged from 6 to 25 months, with a median follow-up time of 13.5(8.0,15.0) months. The primary patency rates after the operation for 6 months and one year were 93.75% and 75.00%, respectively. No stent displacement occurred during the follow-up period.  Conclusion  The through and through technique has shown significant efficacy with a high success rate and a low incidence of complications in the treatment of central venous occlusion in hemodialysis patients, suggesting its clinical applicability.

Key words: Central venous occlusion, Through and through technique, Hemodialysis