Rooijens P P G M, Tordoir J H M, Stijnen T, Burgmans J P J, Smet de A A E A, Yo T I
Department of Surgery, Medical Center Rijnmond Zuid, Location Clara, Rotterdam, The Netherlands.
Eur J Vasc Endovasc Surg. 2004 Dec;28(6):583-9. doi: 10.1016/j.ejvs.2004.08.014.
To improve the precision of the estimates of primary failure rates and primary and secondary 1 year patency of radial-cephalic arteriovenous fistulas (RCAVF) for hemodialysis.
Meta-analysis.
A Medline search was performed of the English language medical literature between January 1970 and October 2002. Key words that were searched included radiocephalic fistula, arteriovenous shunt, Brescia-Cimino fistula and patency. Primary failure, primary and secondary patency rates were analysed using the standard mixed effects model, which allows for variability between the different studies.
Eight prospective and 30 retrospective studies were included. The analysis showed a pooled estimated primary failure rate of 15.3% (95% CI: 12.7-18.3%). In addition, the pooled estimated primary and secondary patency rates of 62.5% (95% CI: 54.0-70.3%) and 66.0% (95% CI: 58.2-73.0%), respectively, were calculated. Subgroup analysis concerning various study characteristics, including study year, gender and age, did not reveal statistically significant differences.
Although, the autogenous RCAVF is considered to be the primary choice for vascular access, this meta-analysis indicates a high primary failure rate and only moderate patency rates at 1 year of follow-up.
提高对用于血液透析的桡动脉-头静脉内瘘（RCAVF）原发性失败率以及原发性和继发性1年通畅率估计的准确性。
荟萃分析。
对1970年1月至2002年10月间的英文医学文献进行了Medline检索。检索的关键词包括桡动脉-头静脉内瘘、动静脉分流、布雷西亚-西米诺内瘘和通畅率。使用标准混合效应模型分析原发性失败、原发性和继发性通畅率，该模型考虑了不同研究之间的变异性。
纳入了8项前瞻性研究和30项回顾性研究。分析显示汇总估计的原发性失败率为15.3%（95%可信区间：12.7 - 18.3%）。此外，分别计算出汇总估计的原发性和继发性通畅率为62.5%（95%可信区间：54.0 - 70.3%）和66.0%（95%可信区间：58.2 - 73.0%）。关于各种研究特征（包括研究年份、性别和年龄）的亚组分析未显示出统计学上的显著差异。
尽管自体RCAVF被认为是血管通路的首选，但这项荟萃分析表明原发性失败率较高，且随访1年时通畅率仅为中等水平。
