PURPOSE:To determine the success and complication rate of coil embolization of arteriovenous fistulae on in situ saphenous vein bypasses. MATERIALS AND METHOD:82 AV-fistulae on 30 bypasses (28 patients, 20 men, age 62.5 +/- 8.3 years) were treated using coils. The success rate, complications, duration, amount of contrast material and radiation exposure were measured. Color-coded duplex sonography was performed 1 - 2 days and up to 6 - 18 months after embolization. RESULTS:The success rate was 68.3 %. The reasons for persistent fistula perfusion were: 96 % fistula not accessible, 4 % reperfusion during thrombolysis. 7 complications were observed in 6 bypasses: failure of placement and retrieving of coil (n = 4), thrombembolic complications with thrombolysis (n = 3). The duration of intervention was 118.3 +/- 46.6 min, the contrast material need was 277.03 +/- 94.0 ml, and the radiation exposure was 10 966 +/- 11 295 cGy/cm (2). Additional balloon dilatation was performed in 30 % of the bypasses. All bypasses were open 1-2 days after intervention. During follow-up, 11 persistent fistulae were detected. CONCLUSIONS:Coil-embolization of arteriovenous fistulae on saphena magna bypasses proved to be a method with moderate success and complication rates.

译文

目的:确定原位大隐静脉旁路手术中动静脉瘘的线圈栓塞术的成功率和并发症发生率。
材料与方法:使用线圈治疗了30例旁路手术中的82例AV瘘管(28例患者,20例男性,年龄62.5 /-8.3岁)。测量成功率,并发症,持续时间,造影剂用量和放射线照射。栓塞后1至2天以及最长6至18个月进行彩色编码的双工超声检查。
结果:成功率为68.3%。持续性瘘管灌注的原因有:96%的瘘管无法通畅,溶栓期间4%的再灌注。在6次旁路中观察到7处并发症:放置和取回线圈失败(n = 4),血栓栓塞并发症并溶栓(n = 3)。干预时间为118.3 /-46.6分钟,造影剂需求为277.03 /-94.0 ml,放射线暴露为10 966 /-11 295 cGy / cm(2)。在30%的旁路中进行额外的球囊扩张。干预后1-2天,所有旁路均打开。在随访期间,发现了11例持续性瘘管。
结论:在巨大隐静脉旁路上动静脉瘘的栓塞术是一种具有中等成功率和并发症发生率的方法。

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