Division of Vascular and Interventional Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710, USA.
J Vasc Interv Radiol. 2012 Jan;23(1):69-74. doi: 10.1016/j.jvir.2011.09.003. Epub 2011 Oct 22.
To determine whether exclusion of pseudoaneurysms with the use of a covered stent in prosthetic arteriovenous (AV) hemodialysis access grafts impacts the incidence of eventual AV graft infection.
Review of an interventional radiology database for prosthetic AV graft interventions involving stent deployment anywhere within the AV graft circuit revealed 235 interventions in 174 patients between November 2004 and December 2008. Incidence of AV graft infection was analyzed based on stent type (bare metal vs covered), location, and indication for stent deployment on a per-stent, per-procedure, and per-graft basis.
A total of 16.3% of the stent-implanted AV grafts were eventually surgically excised as a result of graft infection. Covered stents used to treat an intragraft pseudoaneurysm were more commonly associated with subsequent graft infection compared with bare or covered stents deployed within the graft for other reasons: 42.1% versus 18.2% (P = .011). Stents deployed in an intragraft location were also associated with a higher incidence of graft infection compared with those deployed at the venous anastomosis or outflow vein: 26.9% versus 6.9% (P < .001). No significant difference was identified in infection rates between bare and covered stents.
Covered stent exclusion of intragraft pseudoaneurysms demonstrated a significant correlation with eventual prosthetic AV graft infection.
确定在人造动静脉（AV）血液透析通路移植物中使用带覆盖物的支架排除假性动脉瘤是否会影响最终 AV 移植物感染的发生率。
回顾 2004 年 11 月至 2008 年 12 月期间在介入放射学数据库中进行的涉及 AV 移植物回路内支架部署的人造 AV 移植物介入治疗，发现 174 名患者中的 235 例干预。根据支架类型（裸金属与覆盖物）、支架部署的位置和适应证，对每根支架、每例手术和每根移植物的 AV 移植物感染发生率进行分析。
共有 16.3%的植入支架的 AV 移植物因移植物感染而最终被手术切除。与其他原因（裸金属或覆盖物）植入移植物内的支架相比，用于治疗移植物内假性动脉瘤的带覆盖物的支架更常与随后的移植物感染相关：42.1%比 18.2%（P =.011）。与部署在静脉吻合口或流出静脉处的支架相比，部署在移植物内的支架也与更高的移植物感染发生率相关：26.9%比 6.9%（P <.001）。在感染率方面，裸支架和带覆盖物的支架之间没有显著差异。
带覆盖物的支架排除移植物内假性动脉瘤与最终人造 AV 移植物感染之间存在显著相关性。
