■超声检查更常用于动静脉瘘(AVF)狭窄患者。这项研究的目的是使用超声参数来预测接受超声引导的经皮腔内血管成形术(PTA)治疗的静脉瓣膜相关狭窄(VVRS)的血液透析患者的主要通畅性。
■共纳入在2017年1月至2021年12月期间接受PTA的229例VVRS患者。回顾性收集临床特征。在PTA之前和之后测量超声参数。进行单变量和多变量Cox分析以确定与原发性通畅率相关的独立因素。
■与PTA之前相比,PTA之后所有测得的超声图像参数都得到了改善。在PTA之前,VVRS的直径>1.0mm,年龄≤57岁,体重指数(BMI)>21.57kg/m2与更好的结局相关。而桡动脉的直径,靠近吻合口的近端桡动脉,肱动脉,肱动脉的流量,VVRS的长度和峰值速度(PV),VVRS后的直径和PV与主要通畅率无关。PTA之后,只有VVRS直径>4.0mm的患者有良好的预后.此外,PTA后VVRS直径增加>2.4mm的患者有更好的结局趋势.
■PTA前后VVRS的直径可以作为预测VVRS的AVF患者的初次通畅率和二次通畅率的指标。VVRS的直径增益也可以是潜在的标记。
结论:使用简单的超声参数标记,我们可以快速识别再狭窄风险较高的患者.在早期再狭窄的情况下,应更密切地随访这些患者。它也有利于预防血栓形成。这些措施有助于为长期透析保留更有价值的血管。此外,医生应该更加注意这些危险患者的透析相关并发症,如血液透析相关的低血压。
UNASSIGNED: Ultrasonography is more frequently used in patients with arteriovenous fistula (AVF) stenosis. The aim of this study is to use sonographic parameters for predicting primary patency in hemodialysis patients with venous valve-related stenosis (VVRS) who are treated by ultrasound-guided percutaneous transluminal angioplasty (PTA).
UNASSIGNED: A total of 229 VVRS patients who underwent PTA between January 2017 and December 2021 were enrolled. Clinical characteristics were retrospectively collected. Sonographic parameters were measured both before and after PTA. Univariate and multivariate Cox analyses were performed to identify independent factors associated with primary patency rate.
UNASSIGNED: All measured sonographic parameters improved after PTA compared to before PTA. Before PTA, the diameter of VVRS > 1.0 mm, age ≤ 57 years, and body mass index (BMI) > 21.57 kg/m2 were associated with better outcomes. While the diameter of radial artery, proximal radial artery close to the anastomosis, brachial artery, the flow volume of brachial artery, the length and peak velocity (PV) of the VVRS, and the diameter and PV after the VVRS had no association with the primary patency rate. After PTA, only patients with a diameter of VVRS > 4.0 mm had favorable outcome. In addition, patients with a gain of diameter of VVRS > 2.4 mm after PTA had a trend of better outcomes.
UNASSIGNED: The diameter of VVRS before and after PTA could be served as markers to predict primary patency rate and second patency rate in AVF patients with VVRS. The gain of diameter of VVRS could also be a potential
marker.
CONCLUSIONS: Using simple markers of sonographic parameters, we could quickly identify patients with a higher risk of restenosis. These patients should be followed more closely in case of restenosis at early. It is also beneficial to the prevention of thrombosis. These measures help to preserve more valuable vascular for a long-term dialysis. Additionally, the physician should pay more attention on the dialysis-related complications in these risky patients, such as hemodialysis-related hypotension.