Changes in Regional Ventilation-Perfusion Match Following Percutaneous Transluminal Angioplasty for Arteriovenous Graft Thrombosis
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Electrical Impedance Tomography (EIT) Monitoring.
- Кому может быть актуально
- Состояния в реестре: Arteriovenous Graft Thrombosis, End Stage Renal Disease on Dialysis. Базовые параметры: от 18 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Китай
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
Не всё понятно в терминах? Прочитайте наш гид для пациентов →
Официальное название
Changes in Regional Ventilation-Perfusion Match Following Percutaneous Transluminal Angioplasty for Arteriovenous Graft Thrombosis: A Prospective Observation Pilot Study
Обзор
Patients with end-stage renal disease (ESRD) often require arteriovenous grafts (AVG) for hemodialysis. AVG thrombosis is a common complication, usually managed by percutaneous transluminal angioplasty (PTA) to restore blood flow. PTA achieves patency by balloon-mediated compression and fragmentation of thrombus. Small thrombus fragments may enter the venous circulation and cause transient pulmonary microembolism, leading to ventilation-perfusion (V/Q) mismatch. This study uses electrical impedance tomography (EIT) to noninvasively monitor short-term changes in regional ventilation and perfusion during and after PTA, exploring the immediate pulmonary physiological consequences of thrombus fragmentation and revascularization in dialysis patients.
Подробное описание
Arteriovenous graft (AVG) thrombosis is a major source of vascular access failure in ESRD. PTA restores patency through balloon dilation and mechanical thrombus compression. Minor embolic debris can reach the pulmonary bed, transiently disturbing perfusion distribution and V/Q matching. Because the pulmonary circulation is sensitive to sudden peripheral hemodynamic shifts, the PTA period provides a unique opportunity to observe lung perfusion response dynamically.
This single-center, prospective, observational pilot study will continuously record regional ventilation and perfusion by EIT at six time points: 10 min before PTA, at recanalization, and 10, 20, 30 min after, and at procedure completion. Measured variables include: V/Q matching index (primary), physiological dead space fraction (Vd/Vt), intrapulmonary shunt fraction, SPO₂/FiO₂ ratio, and hemodynamic data (balloon pressure, recanalization time, blood flow recovery). Results will be analyzed using repeated-measures ANOVA or mixed-effects modeling.
Вмешательства
- Диагностический тест Electrical Impedance Tomography (EIT) Monitoring
Non-invasive 16-electrode EIT belt applied at the 4th intercostal level. Continuous data acquisition begins 10 min pre-PTA, continues throughout balloon angioplasty, and up to 30 min post-recanalization. No alteration to standard clinical care.
Первичные конечные точки
- Change in Ventilation-Perfusion Matching Index [Срок оценки: Baseline (10 min before PTA), immediate post-recanalization, 10, 20, 30 minutes, and procedure end.]
Вторичные конечные точки (4)
- Change in Peripheral Oxygen Saturation [Срок оценки: Baseline (10 min before PTA), immediate post-recanalization, 10, 20, 30 minutes, and procedure end.]
- Change in Physiological Dead Space Fraction [Срок оценки: Baseline (10 min before PTA), immediate post-recanalization, 10, 20, 30 minutes, and procedure end.]
- Change in Intrapulmonary Shunt Fraction [Срок оценки: Baseline (10 min before PTA), immediate post-recanalization, 10, 20, 30 minutes, and procedure end.]
- Change in Regional Ventilation and Perfusion Distribution [Срок оценки: Baseline (10 min before PTA), immediate post-recanalization, 10, 20, 30 minutes, and procedure end.]
Критерии участия
Критерии включения
- Age ≥ 18 years.
- Diagnosis of end-stage renal disease receiving maintenance hemodialysis.
- Documented AVG thrombosis requiring PTA.
- Able to cooperate and tolerate EIT monitoring.
- Provided written informed consent.
Критерии исключения
- Severe respiratory failure incompatible with supine position.
- Thoracic skin condition or deformity preventing EIT electrode placement.
- Acute pulmonary embolism or acute pulmonary edema before procedure.
- NYHA Class IV heart failure or hemodynamic instability.
- Pregnancy or breastfeeding.
- Any other circumstance judged unsuitable by investigator.
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Модель наблюдения
- Когортное
Центры проведения
Китай · 1 центр
- The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medic — Wuhu
Идентификаторы
NCT: NCT07613632 · 2026-ICU04