Progress of Endovascular Treatment for Central Venous Stenosis or Occlusion in Hemodialysis Patients

中心静脉疾病是维持性血液透析患者血管通路的严重并发症之一，以中心静脉狭窄或闭塞(Central venous stenosis/occlusion, CVS/O)为主要病理表现。CVS/O可通过引发静脉高压综合征破坏血管通路完整性，显著降低透析充分性并缩短患者总体透析龄。目前，以经皮腔内血管成形术(Percutaneous transluminal angioplasty, PTA)及支架置入术(Stent placement)为核心的血管内介入治疗已成为临床一线治疗方案。尽管腔内治疗能有效恢复短期静脉通畅性并改善通路功能，但术后再狭窄问题仍严重影响远期疗效。本文系统综述CVS/O腔内治疗的技术进展与循证证据，探讨现存挑战及未来研究方向。Central venous disease, manifesting as stenosis or occlusion (CVS/O), represents a critical complication of vascular access in hemodialysis patients. CVS/O can induce severe venous hypertension, compromise vascular access integrity, reduce dialysis adequacy, and shorten overall dialysis vintage. Endovascular interventions, including percutaneous transluminal angioplasty (PTA) and stent placement, are currently first-line therapies. While these minimally invasive approaches effectively restore short-term venous patency and improve access functionality, the persistent challenge of restenosis significantly compromises long-term outcomes. This review synthesizes recent technological advancements and evidence-based practices in endovascular management of CVS/O, while addressing current limitations and future directions.