CONCLUSION

In conclusion, nitinol SMART stent can be effectively used to salvage suboptimal angioplasty results in hemodialysis access venous stenosis not only the central veins but also the peripheral veins including cubital veins. Long-term incidence of nitinol stent fractures in hemodialysis access was more prevalent than suspected (14.5%), especially which were located in peripheral veins. Stent fracture may lead to in-stent restenosis and shorten the primary patency, but not secondary patency.

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개통률은 환자의 성별과 나이, 당뇨와 고혈압의 유무, 스텐트의 직경 및 길이, 스 텐트가 설치된 위치, 혈액투석동정맥루의 종류에 따른 차이가 없었다. 하지만 스 텐트 골절이 있는 집단은 통계학적으로 유의하게 스텐트 골절이 없는 집단보다 일차 개통률이 감소하였다 (p=0.0004). 하지만 이차 개통률는 두 그룹간에 차이가 없었다 (p=0.58). 이차 개통률은 환자의 성별, 당뇨와 고혈압의 유무, 스텐트의 직 경 및 길이, 스텐트가 설치된 위치, 혈액투석동정맥루의 종류, 스텐트 골절에 따 른 차이가 없었다. 하지만 유일하게 65세 이상의 환자 집단이 65세 미만보다 이 차 개통률이 감소하였다 (p=0.045).

결론: Nitinol 스텐트는 동정맥루 협착이 동반된 혈액투석 환자에서 중심정맥뿐 아 니라 말초정맥에도 효과적인 치료법이며 팔꿈치 정맥에서도 다른 위치의 스텐트 와 비교하여 개통률의 유의한 차이가 없었다. 장기 추적 관찰 시에 스텐트 골절 은 알려진 보고들 보다 많이 발생하였고 (14.5%), 한 개의 스텐트 이동이 있었다.

하지만 스텐트 골절은 일차 개통률을 유의하게 감소시켰으나, 이차 개통률에는 유의한 영향을 주지 않았다.

핵심어: Nitinol 스텐트, 개통률, 팔꿈치정맥, 스텐트 골절, 스텐트 이동