关键词: Dialysis access Rib resection Subclavian vein stenosis Surgical decompression Thoracic outlet

Mesh : Humans Arteriovenous Shunt, Surgical Clavicle / diagnostic imaging surgery Decompression, Surgical Osteotomy / adverse effects Renal Dialysis Ribs / surgery Risk Factors Subclavian Vein / diagnostic imaging surgery Thoracic Outlet Syndrome / diagnosis etiology surgery Treatment Outcome Vascular Patency

来  源:   DOI:10.1053/j.semvascsurg.2024.01.004

Abstract:
Patients with threatened arteriovenous access are often found to have central venous stenoses at the ipsilateral costoclavicular junction, which may be resistant to endovascular intervention. Stenoses in this location may not resolve unless surgical decompression of thoracic outlet is performed to relieve the extrinsic compression on the subclavian vein. The authors reviewed the management of dialysis patients with central venous lesions at the thoracic outlet, as well as the role of surgical decompression with first-rib resection or claviculectomy for salvage of threatened, ipsilateral dialysis access.
摘要:
动静脉通路受到威胁的患者常被发现在同侧前锁骨交界处有中心静脉狭窄。这可能对血管内介入有抵抗力。除非进行胸出口手术减压以减轻锁骨下静脉的外部压迫,否则该位置的狭窄可能无法解决。作者回顾了胸廓出口中心静脉病变的透析患者的管理,以及手术减压与第一肋骨切除术或锁骨切除术对挽救先兆的作用,同侧透析通道。
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