覆膜支架治療醫源性股動靜脈內瘺的臨床療效分析（附9例報道）_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

林鴻銘 ^1,2 , 劉婷婷 ² , 江榕 ¹ ,  陳小彬 ^1,2,3 , 黃建強 ¹ ,  林晨 ^1,2,3

1. ;
2. ;
3. ;

Corresponding?author：

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

Keywords：

股動靜脈內瘺; 醫源性; 介入治療; 覆膜支架隔絕術

DOI：

10.7507/1007-9424.202308055

Video：

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目的總結股動靜脈內瘺的發生原因及處理策略，為臨床診治此類疾病提供診療經驗。方法回顧性收集2013年9月至2023年5月期間中國人民解放軍聯勤保障部隊第九〇〇醫院普通外科收治的9例股動靜脈內瘺患者的臨床資料，分析其發生原因、手術方式及治療效果。結果 9例患者的動靜脈內瘺形成均因血管穿刺所致，包括5例房顫患者行射頻導管消融術、3例腦梗死患者行取栓術以及1例尿毒癥患者行臨時血液透析管置入術；9例患者均行覆膜支架隔絕術，經手術治療均治愈，技術成功率為100%。手術時間60～150 min，中位數為90 min；術中出血量10～50 mL，中位數為20 mL；術后住院時間為8～12 d，中位數為10 d。所有患者術后均未聞及血管雜音、患肢腫脹消退。9例患者均獲得隨訪，隨訪時間3～24個月，中位隨訪時間為16個月。隨訪期間均未出現心腦血管疾病等并發癥，超聲復查血管通暢無復發跡象。結論因創傷小、可遠程接近損傷部位、術后感染風險低、住院時間短、失血少等優勢，介入手術可應用于臨床治療股動靜脈內瘺患者。

Citation： 林鴻銘, 劉婷婷, 江榕, 陳小彬, 黃建強, 林晨. 覆膜支架治療醫源性股動靜脈內瘺的臨床療效分析（附9例報道）. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(2): 225-228. doi: 10.7507/1007-9424.202308055 Copy

1.	馬偉, 姜長春. 球囊封堵術閉合醫源性股動靜脈瘺一例. 中國腦血管病雜志, 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.	黃高昇, 郭思恩. Viabahn覆膜支架治療下肢創傷性股動靜脈瘺1例. 介入放射學雜志, 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.	陳梅, 吳盛正, 任秀昀. 超聲造影診斷右側股淺動脈假性動脈瘤及股淺動靜脈瘺1例. 中國介入影像與治療學, 2022, 19(5): 319-320.
11.	孫念, 高傳芬. 超聲對醫源性股動脈假性動脈瘤及動靜脈瘺的診療價值. 醫學信息, 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.	黃天安, 金泳海, 倪才方, 等. Viabahn覆膜支架植入術急診治療醫源性髂股動脈破裂出血. 中國介入影像與治療學, 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. 馬偉, 姜長春. 球囊封堵術閉合醫源性股動靜脈瘺一例. 中國腦血管病雜志, 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. 黃高昇, 郭思恩. Viabahn覆膜支架治療下肢創傷性股動靜脈瘺1例. 介入放射學雜志, 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. 陳梅, 吳盛正, 任秀昀. 超聲造影診斷右側股淺動脈假性動脈瘤及股淺動靜脈瘺1例. 中國介入影像與治療學, 2022, 19(5): 319-320.
11. 孫念, 高傳芬. 超聲對醫源性股動脈假性動脈瘤及動靜脈瘺的診療價值. 醫學信息, 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. 黃天安, 金泳海, 倪才方, 等. Viabahn覆膜支架植入術急診治療醫源性髂股動脈破裂出血. 中國介入影像與治療學, 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

覆膜支架治療醫源性股動靜脈內瘺的臨床療效分析（附9例報道）

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