| Autor: |
Wassmer, Peter, Dharamsey, Shabbir, Mulingtapang, Reynaldo, Griffin, Sylvia, Money, Sam, Jenkins, Stephen, White, Christopher, Ramee, Stephen |
| Zdroj: |
Journal of the American College of Cardiology; February 1995, Vol. 25 Issue: 2, Number 2 Supplement 1 p381A-382A, 2p |
| Abstrakt: |
Central vein occlusion is a common cause of morbidity in patients with upper extremity hemodialysis (HD) access sites and a history of ipsilateral indwelling central lines. We analyzed the results of two percutaneous treatments, balloon angioplasty (PTA) and stenting (S) that were used to relieve symptomatic venous occlusion (arm edema, pain) and improve dialysis efficiency (venous pressure and recirculation fraction). Group I consisted of 26 patients (13 men, 13 women, mean age=62 ± 14.3), with de novo lesions (innominate=5, subclavian=21) who underwent PTA. Group II consisted of 13 patients from Group I who underwent stent implantation (6 Palmaz stents, 7 Wallstents) for failed PTA due to suboptimal angioplasty results (n=5) or restenosis (n=8). We retrospectively compared the acute and long-term clinical success and restenosis rates in these two treatment groups. Acute success was defined as resolution of symptoms and resumption of dialysis. Restenosis was defined as >50% stenosis by angiography. Long-term success @ mean follow-up 14 months was defined as continued dialysis without symptomatic venous occlusion or dialysis graft failure.balloon to prevent cerebral emboli. Six symptomatic patients had 7 PTAs (6 carotids, 1 vertebral).Pt. #Angioplasty TechniqueTranscrania DopplerStenosis Pre→PostComplicationsStenosis 3m F/U1Protected73 emboli90%→20%none10%2Protected40 emboli90%→0%none0%3Active Perf.no window95%→0%none0%4Active Perf.10 emboli99%→0%none0%5Active Perf.no window99→0%hemorrh→death6Standardno window100%→30%→nonepending(vertebral)stent→0%Active Perf.70%→dissec,nonepending(carotid)20%→stent→0% |
| Databáze: |
Supplemental Index |
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