关键词: 动静脉内瘘, AngioJet血栓清除术, 透析通路急性阻塞, 动静脉瘘狭窄 

Abstract: [Abstract] Objective To analyze and evaluate the feasibility and effectiveness of AngioJet thrombus aspiration device combined with balloon dilation for the immediate efficacy and short-term follow-up of 13 patients with acute dialysis access obstruction treated by AngioJet thrombus aspiration device in our hospital. Methods The clinical data of 13 patients with acute dialysis access obstruction treated by AngioJet thrombus aspiration device combined with balloon dilation in our department from 2019 to 2020 were retrospectively analyzed.The preoperative and postoperative arteriovenous fistula tremor,the degree of arteriovenous fistula thrombus obstruction under ultrasound and the blood flow grade before and after thrombolysis in myocardial infarction(TIMI) were analyzed.To evaluate the degree of thrombus clearance and blood perfusion of arteriovenous fistula and evaluate the clinical efficacy. Results 13 patients with acute dialysis access obstruction were treated with AngioJet thrombus aspiration device combined with balloon dilation successfully,the surgical success rate was 100%.Preoperative TIMI grade 0 in 13 cases.Immediately after operation,13 cases were graded 2,and 0 cases were graded 3.During the operation,13 cases of residual stenosis >50% were treated with high pressure balloon dilatation and angioplasty.After angiography,13 cases received TIMI grade 3.The 13 patients recovered tremor immediately after treatment,and color ultrasound 24 hours after surgery indicated that the diameter of the arteriovenous fistula drainage vein was ≥5mm,and the blood flow was >500ml/min.No serious complications such as digestive tract and intracranial hemorrhage were observed in the 13 patients.After 6 months of outpatient follow-up,13 patients were discharged:the arteriovenous fistula tremor was good;D-dimer <0.55ng/L;TIMI grade 2 in 3 cases and grade 3 in 10 cases;Ultrasonography showed that the blood flow in the arteriovenous internal fistula was patency in 13 patients,and the blood flow was >500ml/min.Able to meet dialysis requirements. Conclusion AngioJet thrombus aspiration device combined with balloon dilation in the treatment of patients with acute obstruction of dialysis access has the following characteristics:less surgical trauma,fewer complications,high fistula preservation rate,simple operation and definite curative effect.

Key words: arteriovenous fistula, AngioJet thrombotomy, acute obstruction of dialysis access, arteriovenous fistula stenosis