CTA定位下Fogarty球囊导管取栓术在动静脉内瘘失功中的应用  

Application of Fogarty catheters embolectomy in arterial-venous fistula dysfunction via computerized topographic angiography

作　　者：陈舜杰[1] 陆玮[1] 季刚[1] 黄海东[1] 单剑萍[1] 蒋更如[1] 

机构地区：[1]上海交通大学医学院附属新华医院肾脏科,上海市200092

出　　处：《中华实用诊断与治疗杂志》2008年第8期589-591,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的：观察在CT血管造影三维重建定位下应用Fogarty球囊导管取栓治疗自体动静脉内瘘失功的近期和远期临床效果。方法：采用电子计算机断层扫描血管造影,间断或连续摄影观察,检查结束后进行数据处理,图像三维重建,观察失功的内瘘的血管狭窄情况或血栓的数量以及位置。在内瘘原吻合口稍上方切开瘘管,选用大小恰当的Fogarty导管,在球囊萎瘪的状态下轻柔地插入血管腔,导管穿过血栓或狭窄部位,注入肝素盐水使导管膨胀,利用水囊对栓子的牵拉作用将血栓取出。结果：40例患者34例采用Fogarty导管取栓成功,血液透析时血流量可达200 mL/min以上。其中长期随访31例,随访12-38个月,3例再次发生动静脉内瘘血栓形成,分别发生在术后第14、20、37个月。结论：CT血管造影三维重建定位下Fogarty导管取栓术应用于动静脉内瘘血栓形成、尤其是离瘘口较远的血栓效果良好延长了自体动静脉内瘘的使用寿命。Objective To observe the clinical effects in the short-and long-term of the application of Fogarty catheters embolectomy in autoallergic arterial-venous fistula dysfunction via computerized topographic angiography.Methods The number and location of the thrombosis and angiostegnosis in the dysfunctioned arterial-venous fistula were observed via computerized topographic angiography.After incision of the syrinx on the slightly anodic position above arch internal fistula stoma,the appropriated size of Fogarty catheter was inserted slightly into the lumen of blood vessel when the sacculus proprius was flat.Injecting heparinate brine into the sacculus proprius to be expansed after the Fogarty catheter permeating through the thrombus or the position of angusty,thrombus was taken out by the drag of water sac.Results Thirty-four cases succeeded in Fogarty catheters embolectomy in 40 patients,the blood flow reached to 200 mL/min or above.Thirty-one patients were followed up in the term of 12 to 38 months.Thrombosis in internal arteriovenous fistula happened respectively in the 34th,20th,37th months in the 3 cases.Conclusion Fogarty catheters embolectomy via computerized topographic angiography are effective in autoallergic arterial-venous fistula dysfunction especially in the thrombus far from the orificium fistulae.The technology lengthens the service life of autoallergic arterial-venous fistula.

关 键 词：动静脉内瘘 CT血管造影三维血管重建 FOGARTY导管 

分 类 号：R459.5[医药卫生—治疗学]