Objective To evaluate the effect of Viabahn endograft on central venous stenosis (CVS) in hemodialysis patients.Methods A total of 18 hemodialysis patients who were diagnosed as CVS and treated by Viabahn endografting from January 2015 to September 2016 in our center were retrospectively reviewed.Results All patients showed significant clinical symptoms and signs,and were diagnosed as CVS with venography.Viabahn endograft was implanted if elastic recoil occmred or there was significant residual stenosis＞30％ after percutaneous transluminal anioplasty (PTA),or restenosis in the short term.A total of 18 consecutive patients with CVS were treated with 18 Viabahn endografls,with another 2 Viabahn endografls implanted for recurrence.All patients were followed up for 2～21 months.Primary patency rate was 85.2％ at 6 months and 75.8％ at 12 months.Assisted primary patency rate was 100％.Conclusion PTA is considered the first-line therapy in the treatment of CVS in hemodialysis patients.PTA and baremetal stent have a low patency rate.The use of the Viabahn endograft in the management of CVS in hemodialysis shows encouraging early patency rate,while the longer patency rate needs to be further studied.%目的 探讨Viabahn覆膜支架用于血液透析患者中心静脉狭窄的临床疗效.方法 回顾性分析本院2015年1月至2016年9月收治的18例中心静脉狭窄的血液透析患者的临床资料.结果通过临床症状、体征和静脉造影检查,18例血液透析患者确诊为中心静脉狭窄.行经皮腔内血管成形术(PTA)后发生弹性回缩或残余狭窄＞30％,或伴有PTA术后短期出现再狭窄,植入Viabahn覆膜支架.一期植入18枚Viabahn血管内覆膜支架,二期再狭窄植入2枚.随访2～21个月.术后6个月和12个月的一期支架通畅率为85.2％和75.8％,一期辅助通畅率为100％.结论 血液透析患者中心静脉狭窄治疗首选PTA,但PTA和金属裸支架(BMS)通畅率较低,对于中心静脉再狭窄的患者使用新型Viabahn血管内覆膜支架近期通畅率令人满意,远期通畅率有待进一步观察.
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