Characteristics and percutaneous transluminal angioplasty treatment outcomes of superior vena cava obstruction in patients undergoing hemodialysis.

IF 1.4 4区医学 Q3 PERIPHERAL VASCULAR DISEASE International Angiology Pub Date : 2024-12-01 DOI:10.23736/S0392-9590.24.05347-1

Ran Tian, Zhengli Tan, Zhengya Yu

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Abstract

Background: This study aimed to investigate the clinical outcomes of percutaneous transluminal angioplasty (PTA) in patients undergoing hemodialysis with different types of superior vena cava obstruction (SVCO) lesions.

Methods: This retrospective observational study recruited patients undergoing hemodialysis with SVCO and analyzed the clinical characteristics of SVCO. Patency rates were collected for patients treated with PTA and were assessed using the t-test, U-test, log-rank test and survival analyses such as the Kaplan-Meier method.

Results: A total of 49 patients undergoing hemodialysis with SVCO were classified as type I (N.=17), type II (N.=7), type III (N.=15) and type IV (N.=10). All patients had a history of catheter placement. There were 14 cases of SVCO-related catheter dysfunction, and PTA was performed in 35 patients with a technical success rate of 77.14% (27/35). Failures were observed exclusively in eight patients with type III or IV lesions. The median follow-up was 15 (1.5-58) months, with 6- and 12-month post-PTA primary patency rates of 51.9% and 14.4%, respectively. The primary assisted patency rates were 70.2% and 55.2%, and the secondary patency rates were 92.6% and 78.0%, requiring 2.68 PTAs per patient per year to maintain them. Type I-II lesions demonstrated significantly higher primary patency and primary assisted patency rates than type III-IV lesions (P=0.007 and P=0.002).

Conclusions: Percutaneous transluminal angioplasty may be used to treat type I or II SVCO, achieving high technical success and patency rates. Patients undergoing hemodialysis with SVCO may have a condition related more to catheter placement than to arteriovenous fistula.

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血液透析患者上腔静脉阻塞的特点及经皮腔内血管成形术治疗效果。

背景：本研究旨在探讨不同类型上腔静脉阻塞（SVCO）病变的血液透析患者经皮腔内血管成形术（PTA）的临床效果。方法：回顾性观察性研究，招募血液透析伴SVCO患者，分析SVCO的临床特点。收集PTA治疗患者的通畅率，并使用t检验、u检验、log-rank检验和Kaplan-Meier法等生存分析进行评估。结果：49例伴有SVCO的血液透析患者分为I型（17例）、II型（7例）、III型（15例）和IV型（10例）。所有患者均有置管史。svco相关性导管功能障碍14例，35例患者行PTA，技术成功率77.14%（27/35）。仅在8例III型或IV型病变患者中观察到失败。中位随访时间为15（1.5-58）个月，pta后6个月和12个月原发性通畅率分别为51.9%和14.4%。初级辅助通畅率分别为70.2%和55.2%，二级辅助通畅率分别为92.6%和78.0%，每例患者每年需要2.68个pta来维持通畅。I-II型病变的原发性通畅率和原发性辅助通畅率明显高于III-IV型病变（P=0.007和P=0.002）。结论：经皮腔内血管成形术可用于治疗I型或II型SVCO，技术成功率高，通畅率高。接受血液透析的SVCO患者可能与导管放置的关系大于与动静脉瘘的关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Angiology 医学-外周血管病

CiteScore

2.80

自引率

28.60%

发文量

审稿时长

6-12 weeks

期刊介绍： International Angiology publishes scientific papers on angiology. Manuscripts may be submitted in the form of editorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work. Duties and responsibilities of all the subjects involved in the editorial process are summarized at Publication ethics. Manuscripts are expected to comply with the instructions to authors which conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Editors by the International Committee of Medical Journal Editors (ICMJE).