ỨNG DỤNG KỸ THUẬT CAN THIỆP NỘI MẠCH ĐIỀU TRỊ HẸP TẮC TĨNH MẠCH TRUNG TÂM Ở BỆNH NHÂN CHẠY THẬN NHÂN TẠO

Abstract

Introduction: The prevalence of chronic kidney disease (CKD) is increasing both globally and in Vietnam. To maintain regular hemodialysis, arteriovenous fistulas (AVFs) play an essential role. A common issue associated with AVFs is the stenosis or occlusion of the return veins, including central venous stenosis (CVS), which reduces the efficiency of dialysis and impacts patients' quality of life. Methods: This study applied percutaneous transluminal angioplasty (PTA) with or without stent placement to treat CVS. Selected patients were those undergoing regular hemodialysis and presenting symptoms of central venous stenosis. Results: Over the study period from January 2020 to April 2024, 31 CKD patients undergoing regular hemodialysis with CVS were treated with endovascular intervention at the Department of Vascular Surgery, Chợ Rẫy Hospital. The intervention success rate was 87.1%, with significant clinical improvement in symptoms such as arm swelling, arm pain, and subcutaneous collateral circulation. Conclusion: Endovascular intervention techniques have proven effective in treating CVS, demonstrating a high success rate and improved patient quality of life. Covered stents are recommended to reduce the risk of restenosis and protect the vessel wall, especially in cases of severe stenosis, recurrent stenosis, or high risk of restenosis.