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논문분류	춘계학술대회 초록집
제목	A case of simultaneous percutaneous transluminal angioplasty for both arm AV access stenosis
저자	HEERYONG LEE
출판정보	2023; 2023(1):
키워드
초록	A 63-year-old female patient was admitted to our hospital with hemostasis problems. The patient was undergoing hemodialysis treatment after left upper straight arteriovenous graft(AVG) surgery in April 2019. However, due to repeated stenosis and thrombosis, radiocephalic arteriovenous fistula(AVF) surgery was performed on the right arm in May 2021. According to ultrasonographic findings, 80% stenosis was observed in the venous anastomosis of AVG on the left side, and PTA was determined. At the same time, 90% stenosis of the outflow vein was observed in the right vascular access ultrasound examination, and on physical examination, thrill decreased and pulsation was observed. Both sides of the vascular access needed treatment, so wiring was performed by inserting a 7Fr sheath into the left graft. After entering the left brachiocephalic vein, the wire did not enter the SVC, but passed through the opposite innominate vein, passed through the subclavian vein, axillary vein, and basilica vein, and entered the radial artery. First, balloon dilatation was performed with a 7*60mm balloon located at the stenotic lesion of the right arm, and it was confirmed that the stenosis disappeared. After that, dilatation was performed with the same balloon catheter on the stenotic lesion of the left arm, and the stenosis disappeared and the blood flow improved, and the procedure was completed. When wiring from left to right, there was difficulty in continuously directing the wire to the SVC according to the flow of blood flow, but wiring was successfully performed after locating it in the direction of the right innominate vein as a diagnostic catheter. Conclusions: In hemodialysis patients with bilateral vascular access, inserting a sheath from one side to solve the bilateral problem can be an alternative treatment that can reduce the pain of bilateral puncture for the patient.
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