血液透析通路狭窄.pptx

READ论坛 2016.5 ;透析通路的重要性;临床问题;内瘘通路转归 ;Primary Patency @ 3 years;;;内瘘吻合口狭窄机制;影响PTA治疗结果的因素;50%;DEB 35%: Primary Patency @ 12 months;支架植入术;支架植入术—Reasonable？;从指南到实践;金属裸支架植入术;金属裸支架 ;Sullivan TM et al J Vasc Surg 2002; 36:143-149;;覆膜支架;instent restenosis in open stents;覆膜支架适应症;覆膜支架植入术-头静脉;覆膜支架植入术;覆膜支架初步结果;The Gore REVISE Clinical Study was a multicenter, randomized-controlled trial evaluating the safety and effectiveness of the GORE? VIABAHN? Endoprosthesis in treating stenosis or thrombotic occlusions of a synthetic arteriovenous (AV) access graft at the venous anastomosis.;GORE?, VIABAHN?, and designs are trademarks of W. L. Gore Associates. ? 2014 W. L. Gore Associates, Inc.;中心静脉狭窄的腔内治疗;男, 51yrs 右上肢肿胀1年 右AVF(桡A- 头V) 血透5 yrs 右上肢肿胀 右上肢、肩部浅静脉曲张;;术前准备;Failed;头V穿刺 7F 55cm Cook sheath 5F Vertibral Cath Stiff Terumo wire(0.035);Admiral球囊 10*40mm;支架 ( Cordis 14-60);P3 球囊 (12-40);;抗凝治疗1-3天 抗血小板治疗 Plavix 75mg/D 至少3月 后阿司匹林100mg/D;国外经验;中心静脉再次闭塞后内瘘血管的腔内栓塞术;小 结;