Abstract:
Dialysis access thrombosis is a common complication in the process of care. With the introduction of endovascular AV-fistulas [AVF]s the situation gained complexity with new potential thrombosis localizations. Several thrombectomy methods are available for recanalization of thrombosed AVFs ranging from invasive surgical methods to minimal invasive endovascular approaches. Early assessment, diagnosis and treatment is crucial for prolonging the life span of an AVF and preventing the need for placement of central venous catheters. To our best knowledge, we present the first case in which an obstructed antecubital communicating vein (aka perforating vein) of an endovascular created AVF was re-opened via interventional thrombectomy with the Rotarex® System (BD Interventional). The procedure was performed primarily under ultrasound guidance with fluoroscopic support. Our case report shows that this method, if done correctly and successfully, may prevent loss of the dialysis access. Additionally, we point towards the central role of ultrasound in this method.
摘要:
透析通路血栓形成是护理过程中常见的并发症。随着血管内房室瘘[AVF]的引入,新的潜在血栓形成定位使情况变得更加复杂。几种血栓切除术方法可用于血栓形成的AVF的再通,范围从侵入性手术方法到微创血管内方法。早期评估,诊断和治疗对于延长AVF的寿命和不需要放置中心静脉导管至关重要.据我们所知,我们介绍了第一例,其中通过Rotarex®系统(BDInterventional)介入性血栓切除术重新开放血管内形成的AVF的肘前交通静脉(又称穿支静脉).该程序主要在荧光透视支持的超声引导下进行。我们的病例报告显示,这种方法,如果正确和成功地完成,可以防止失去透析通路。此外,我们指出超声在这种方法中的核心作用。