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Endovascular treatment of central venous stenosis and obstruction in hemodialysis patients

Chinese Medical Journal 2013年第3期126卷 426-430页

作者： SHI Ya-xue YE Meng LIANG Wei ZHANG Hao ZHAO Yi-ping ZHANG Ji-wei Department of Vascular Surgery Renji Hospital Shanghai Jiao Tong University School of Medcine Shanghai 200001 China

Background Central venous stenosis and obstruction （CVD） is a serious and prevalent challenge to both resolve the venous hypertension symptoms and maintain the pantency of the ipsilateral hemodialysis access in hemodialysis patients. This study aimed to summarize our experience of the endovascular management of the central venous stenosis or obstruction in hemodialysis patients. Methods Twenty-four haemodialysis cases of central vein stenosis or obstruction with ipsilateral functional vascular access in our hospital between July 2006 and February 2012 were treated by interventional therapy and the data were analyzed retrospectively. Results Eighteen males and six females with mean age of （66.4±13.8） years and manifesting with arm swelling and venous hypertension were enrolled; 62.5% of them had a history of catheterization. Venography showed stenotic lesion in 10 cases including eight cases of brachiocephalic vein stenosis and two cases of subclavian vein stenosis and 14 cases of obstruction lesions including seven cases of short brachiocephalic obstruction and seven cases of long segment obstruction. Interventional therapy was performed and the technique success rate was 83.3%. percutaneous transluminal angioplasty （PTA） was performed in nine cases and stent was performed in 11 cases firstly. The symptoms of venous hypertension were resolved after intervention in all the cases. There was no major complication and death perioperatively. During follow-up, reintervention was done, the primary patency rates were （88.9±10.5）%, （64.8±10.5）% and （48.6±18.7）% at 3 months, 6 months and 1 year after treatment in the PTA group; （90.0±9.5）% and （77.1±14.4）% at 6 months and 1 year after treatment in the stent group, respectively. The secondary patency rates were （48.6±18.7）% in the PTA group and （83.3±15.2）% in the stent group 1 year after treatment, respectively. There was no significant difference between the two groups （primary patency, P=0.20; secondary patency, P=0.10）. Co

关键词： central venous stenosis hemodialysis percutaneous angioplasty stent

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Specialty Balloons and Vessel Prepping in Peripheral Artery Disease

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Open Journal of Internal Medicine 2022年第2期12卷 95-102页

作者： Katon Harwood Ariana Harwood James Cappola III Campbell University School of Osteopathic Medicine Lillington NC USA

Peripheral Artery Disease (PAD) is a global disease that affects more than 200 million individuals worldwide with an ever-increasing prevalence rate from year to year. Peripheral Artery Disease treatments include everything from lifestyle interventions to surgical revascularization or percutaneous angioplasty (PTA). percutaneous angioplasty (PTA) has become the primary treatment for this disease with the use of focal force and scoring balloons for vessel prepping. The practice of vessel prepping looks to limit the effect of angioplasty on vessel dissection and recoiling in the infrainguinal region during the treatment of plaque buildup in the vessel. Plaque morphology and rise in incidence of in-stent restenosis can determine which balloon device is best used when restoring a vessel. Some of the different brands we review in this chapter include Peripheral Cutting Balloons by Boston Scientific, Chocolate PTA by Medtronic, Angiosculpt balloon by Philips, and VascuTrak by BARD. In review of Angiosculpt balloon by Philips: The study concluded that the one-year data supports the notion that the AngioSculpt Scoring Balloon is an effective and safe treatment option for infrapopliteal, atherosclerotic lesions in patients with critical limb ischemia. Whereas: Peripheral cutting balloons (PCBs) by Boston Scientific have been used for in-stent restenosis, resistant lesions, small vessels, bifurcations, aortaostial lesions, and saphenous vein graft lesions. This chapter will discuss different focal force and scoring balloon devices available to treat different plaque morphology and usefulness for in-stent restenosis resolution. We will review the evidence associated with each brand of device and the factors that should be accounted for before making a decision on which to use for your patient.

关键词： Peripheral Artery Disease Vessel Prepping percutaneous angioplasty

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