覆膜支架治疗医源性股动静脉内瘘的临床疗效分析（附9例报道）_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

林鸿铭 ^1,2 , 刘婷婷 ² , 江榕 ¹ ,  陈小彬 ^1,2,3 , 黄建强 ¹ ,  林晨 ^1,2,3

1. ;
2. ;
3. ;

Corresponding author：

陈小彬, Email: cxb104189@126.com; 林晨, Email: chenlin.med@hotmail.com

Keywords：

股动静脉内瘘; 医源性; 介入治疗; 覆膜支架隔绝术

DOI：

10.7507/1007-9424.202308055

Video：

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目的总结股动静脉内瘘的发生原因及处理策略，为临床诊治此类疾病提供诊疗经验。方法回顾性收集2013年9月至2023年5月期间中国人民解放军联勤保障部队第九〇〇医院普通外科收治的9例股动静脉内瘘患者的临床资料，分析其发生原因、手术方式及治疗效果。结果 9例患者的动静脉内瘘形成均因血管穿刺所致，包括5例房颤患者行射频导管消融术、3例脑梗死患者行取栓术以及1例尿毒症患者行临时血液透析管置入术；9例患者均行覆膜支架隔绝术，经手术治疗均治愈，技术成功率为100%。手术时间60～150 min，中位数为90 min；术中出血量10～50 mL，中位数为20 mL；术后住院时间为8～12 d，中位数为10 d。所有患者术后均未闻及血管杂音、患肢肿胀消退。9例患者均获得随访，随访时间3～24个月，中位随访时间为16个月。随访期间均未出现心脑血管疾病等并发症，超声复查血管通畅无复发迹象。结论因创伤小、可远程接近损伤部位、术后感染风险低、住院时间短、失血少等优势，介入手术可应用于临床治疗股动静脉内瘘患者。

Citation： 林鸿铭, 刘婷婷, 江榕, 陈小彬, 黄建强, 林晨. 覆膜支架治疗医源性股动静脉内瘘的临床疗效分析（附9例报道）. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(2): 225-228. doi: 10.7507/1007-9424.202308055 Copy

1.	马伟, 姜长春. 球囊封堵术闭合医源性股动静脉瘘一例. 中国脑血管病杂志, 2023, 20(1): 36-40.
2.	Perings SM, Kelm M, Jax T, et al. A prospective study on incidence and risk factors of arteriovenous fistulae following transfemoral cardiac catheterization. Int J Cardiol, 2003, 88(2-3): 223-228.
3.	Hashimoto S, Banshodani M, Marubayashi S, et al. Iatrogenic arteriovenous fistula in the brachial artery after percutaneous coronary intervention in a patient with end stage kidney disease. J Vasc Access, 2023: 11297298231158427.
4.	Rama-Merchan JC, Cruz-González I, Martín-Moreiras J, et al. Percutaneous closure of iatrogenic femoral arteriovenous fistula using a covered coronary stent. Rev Port Cardiol, 2017, 36(3): 219.e1-219.e4.
5.	黄高昇, 郭思恩. Viabahn覆膜支架治疗下肢创伤性股动静脉瘘1例. 介入放射学杂志, 2022, 31(10): 1031-1033.
6.	Kuramochi G, Ohara N, Hasegawa S, et al. Femoral arteriovenous fistula: a complication of temporary hemodialysis catheter placement. J Artif Organs, 2006, 9(2): 114-117.
7.	Tohmasi S, Kabutey NK, Chen SL, et al. Iatrogenic arteriovenous fistula formation after endovenous laser treatment resulting in high-output cardiac failure: a case report and review of the literature. Ann Vasc Surg, 2021, 72: 666.e13-666.e21.
8.	Pandey NN, Kumar S. Delayed presentation of a post-traumatic lower extremity arteriovenous fistula. Indian J Med Res, 2020, 152(Suppl 1): S69.
9.	Stathis A, Gan J. Traumatic arteriovenous fistula: a 25-year delay in presentation. J Surg Case Rep, 2020, 2020(3): rjaa042. doi: 10.1093/jscr/rjaa042.
10.	陈梅, 吴盛正, 任秀昀. 超声造影诊断右侧股浅动脉假性动脉瘤及股浅动静脉瘘1例. 中国介入影像与治疗学, 2022, 19(5): 319-320.
11.	孙念, 高传芬. 超声对医源性股动脉假性动脉瘤及动静脉瘘的诊疗价值. 医学信息, 2021, 34(12): 172-175.
12.	Bounssir A, Taghi H, Sedki N, et al. Technical management of traumatic arteriovenous fistula: tips and tricks. Int J Surg Case Rep, 2020, 76: 468-473.
13.	黄天安, 金泳海, 倪才方, 等. Viabahn覆膜支架植入术急诊治疗医源性髂股动脉破裂出血. 中国介入影像与治疗学, 2020, 17(2): 89-92.
14.	Nasser Eldine R, Dehaini H, Hoballah JJ, et al. Management of dual traumatic arterial-venous fistula from a single shotgun injury: a case report and literature review. BMC Surg, 2020, 20(1): 177. doi: 10.1186/s12893-020-00833-5.
15.	Raymundo SRO, Leite RLT, Reis LF, et al. Traumatic arteriovenous fistula with serious haemodynamic repercussions: endovascular treatment. BMJ Case Rep, 2020, 13(4): e234220. doi: 10.1136/bcr-2019-234220.
16.	DeWane MP, Fares WH, Ochoa Chaar CI. Endovascular treatment of a large iliac vein aneurysm and high-flow arteriovenous fistula. Ann Vasc Surg, 2018, 53: 266.e5-266.e7.
17.	Sobolev M, Shiloh AL, Di Biase L, et al. Ultrasound-guided cannulation of the femoral vein in electrophysiological procedures: a systematic review and meta-analysis. Europace, 2017, 19(5): 850-855.

1. 马伟, 姜长春. 球囊封堵术闭合医源性股动静脉瘘一例. 中国脑血管病杂志, 2023, 20(1): 36-40.
2. Perings SM, Kelm M, Jax T, et al. A prospective study on incidence and risk factors of arteriovenous fistulae following transfemoral cardiac catheterization. Int J Cardiol, 2003, 88(2-3): 223-228.
3. Hashimoto S, Banshodani M, Marubayashi S, et al. Iatrogenic arteriovenous fistula in the brachial artery after percutaneous coronary intervention in a patient with end stage kidney disease. J Vasc Access, 2023: 11297298231158427.
4. Rama-Merchan JC, Cruz-González I, Martín-Moreiras J, et al. Percutaneous closure of iatrogenic femoral arteriovenous fistula using a covered coronary stent. Rev Port Cardiol, 2017, 36(3): 219.e1-219.e4.
5. 黄高昇, 郭思恩. Viabahn覆膜支架治疗下肢创伤性股动静脉瘘1例. 介入放射学杂志, 2022, 31(10): 1031-1033.
6. Kuramochi G, Ohara N, Hasegawa S, et al. Femoral arteriovenous fistula: a complication of temporary hemodialysis catheter placement. J Artif Organs, 2006, 9(2): 114-117.
7. Tohmasi S, Kabutey NK, Chen SL, et al. Iatrogenic arteriovenous fistula formation after endovenous laser treatment resulting in high-output cardiac failure: a case report and review of the literature. Ann Vasc Surg, 2021, 72: 666.e13-666.e21.
8. Pandey NN, Kumar S. Delayed presentation of a post-traumatic lower extremity arteriovenous fistula. Indian J Med Res, 2020, 152(Suppl 1): S69.
9. Stathis A, Gan J. Traumatic arteriovenous fistula: a 25-year delay in presentation. J Surg Case Rep, 2020, 2020(3): rjaa042. doi: 10.1093/jscr/rjaa042.
10. 陈梅, 吴盛正, 任秀昀. 超声造影诊断右侧股浅动脉假性动脉瘤及股浅动静脉瘘1例. 中国介入影像与治疗学, 2022, 19(5): 319-320.
11. 孙念, 高传芬. 超声对医源性股动脉假性动脉瘤及动静脉瘘的诊疗价值. 医学信息, 2021, 34(12): 172-175.
12. Bounssir A, Taghi H, Sedki N, et al. Technical management of traumatic arteriovenous fistula: tips and tricks. Int J Surg Case Rep, 2020, 76: 468-473.
13. 黄天安, 金泳海, 倪才方, 等. Viabahn覆膜支架植入术急诊治疗医源性髂股动脉破裂出血. 中国介入影像与治疗学, 2020, 17(2): 89-92.
14. Nasser Eldine R, Dehaini H, Hoballah JJ, et al. Management of dual traumatic arterial-venous fistula from a single shotgun injury: a case report and literature review. BMC Surg, 2020, 20(1): 177. doi: 10.1186/s12893-020-00833-5.
15. Raymundo SRO, Leite RLT, Reis LF, et al. Traumatic arteriovenous fistula with serious haemodynamic repercussions: endovascular treatment. BMJ Case Rep, 2020, 13(4): e234220. doi: 10.1136/bcr-2019-234220.
16. DeWane MP, Fares WH, Ochoa Chaar CI. Endovascular treatment of a large iliac vein aneurysm and high-flow arteriovenous fistula. Ann Vasc Surg, 2018, 53: 266.e5-266.e7.
17. Sobolev M, Shiloh AL, Di Biase L, et al. Ultrasound-guided cannulation of the femoral vein in electrophysiological procedures: a systematic review and meta-analysis. Europace, 2017, 19(5): 850-855.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

覆膜支架治疗医源性股动静脉内瘘的临床疗效分析（附9例报道）

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