目的分析动静脉内瘘(人工血管动静脉内瘘、自身动静脉内瘘)腔内治疗时发生血管破裂情况及其处理。方法2012 年04 月～2016 年07 月无锡市人民医院共对200 名内瘘失功患者进行腔内治疗，治疗过程中出现血管破裂7 例。其中6 例即刻发现破裂，1 例为延迟破裂。其中4 例血管破裂(包括2例人工血管动静脉内瘘、2 例自身动静脉内瘘)置入覆膜支架，2 例破裂放弃治疗，1 例局部压迫止血。结果所有4 名患者均成功置入覆膜支架，造影明确完全封堵破口，术后患者均可立即进行血液透析。其中1 例患者置入支架后6 个月因人工血管增生致内瘘失功，余患者随访1、19、20 个月，期间无再发血管破裂，内瘘通畅。结论动静脉内瘘破裂是腔内治疗过程中一种少见但危险的并发症，应用覆膜支架封闭破口是一种安全、微创、有效的治疗方法。

Objecctive To evaluate the treatment of arteriovenous fistula rupture during endovascular manipulationt for graft and fistula. Methods In the period from April 2012 to July 2016, arteriovenous fistula rupture happened 7 times in 200 patients during endovascular manipulation in our hospital. Six ruptures happened intraoperatively, and one was of delayed rupture. Covered stents were implanted in 4 of these ruptures, 2 patients refused further treatment, and one patient was treated with compression. Results Covered stents were successfully implanted for the 4 patients, and the fistulas could be used for blood access immediately, However, dysfunctioning of the fistula due to vascular proliferation occurred in one patient after stent implantation for 6 months. The other 3 patients were followed up for 1 to 20 moths without recurrence of rupture and stenosis. Conclutions Hemodialysis access rupture is a rare but serious complication during endovascular manipulation. Covered stent provided a safe and effective treatment for this complication.