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首页> 外文期刊>AJR: American Journal of Roentgenology : Including Diagnostic Radiology, Radiation Oncology, Nuclear Medicine, Ultrasonography and Related Basic Sciences >Evaluation of immature hemodialysis arteriovenous fistulas based on 3-french retrograde micropuncture of brachial artery
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Evaluation of immature hemodialysis arteriovenous fistulas based on 3-french retrograde micropuncture of brachial artery

机译：基于臂丛动脉三瓣逆行微穿刺的未成熟血液透析动静脉瘘评估

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OBJECTIVE. The objective of our study was to assess outcomes after evaluation of immature hemodialysis arteriovenous fistulas (AVFs) via 3-French brachial artery access and to identify the incidence of arterial and venous puncture site spasm. MATERIALS AND METHODS. One hundred twenty-three outpatients (82 men, 41 women; mean age, 58 years; age range, 20-90 years) with immature AVF were identified retrospectively in whom diagnostic fistulography was performed via 3-French retrograde brachial artery puncture. Percutaneous transluminal angioplasty was performed via a separate venous puncture during the same visit in 95 patients. Patient age and sex, fistula age and type, and technical success and complications were recorded. Images were reviewed for lesion location, potentially competing vessels, and arterial and venous puncture-related spasms. RESULTS. The mean fistula age was 99 days (range, 21-639 days). There were 49 AVFs in the left forearm; 30 in the left upper arm; 26 in the right forearm; and 18 in the right upper arm. Twenty-eight AVFs were transposed. Angioplasty was technically successful in 81 of 95 patients (85%; mean diameter, 7 mm; range, 4-10 mm). Brachial artery puncture caused no major complication. Arterial spasm occurred in 19 patients (15%) and was severe in one patient. There were two hematomas (1.6%). Venous spasm, ranging from mild (four patients) to occlusive (8 patients), occurred in 38 patients (40%) at the site of venipuncture for intervention. Nitroglycerin (mean, 325 mcg; range, 100-600 mcg) was used in 26 procedures (21%). Venous spasm was more common with forearm (50%) than upper arm (24%) fistulas (p = 0.02) and with decreasing vein diameter (p = 0.02). CONCLUSION. Evaluation of immature AVFs based on 3-French micropuncture of the brachial artery can be safely performed on an outpatient basis. Spasm is more common in forearm AVFs and in smaller veins.
机译：目的。我们研究的目的是评估通过3法式肱动脉介入评估未成熟血液透析动静脉瘘（AVF）后的结果，并确定动脉和静脉穿刺部位痉挛的发生率。材料和方法。回顾性分析了未成熟AVF的123例门诊患者（男82例，女41例;平均年龄58岁;年龄范围20-90岁），他们通过3法逆行肱动脉穿刺进行了诊断性瘘管造影。在95位患者的同一次就诊期间，通过单独的静脉穿刺进行了经皮腔内血管成形术。记录患者的年龄和性别，瘘管的年龄和类型以及技术成功率和并发症。审查图像的病变部位，潜在竞争的血管以及与动脉和静脉穿刺相关的痉挛。结果。平均瘘管年龄为99天（范围21-639天）。左前臂有49个AVF。左上臂30个;右前臂26;和右上臂18。 28个AVF进行了转置。 95例患者中有81例在技术上获得了成功的血管成形术（85％;平均直径7 mm;范围4-10 mm）。肱动脉穿刺未引起大的并发症。动脉痉挛发生在19例患者中（15％），其中1例严重。有两个血肿（1.6％）。在静脉穿刺部位发生静脉痉挛，范围从轻度（4例）到闭塞（8例），其中38例（40％）发生。硝酸甘油（平均325 mcg;范围100-600 mcg）用于26个步骤（21％）。前臂静脉痉挛（50％）比上臂瘘（24％）更常见（p = 0.02），静脉直径减小（p = 0.02）。结论。可以在门诊患者的基础上安全地进行基于肱动脉三法微穿刺的未成熟AVF评估。痉挛在前臂AVF和较小的静脉中更为常见。

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