Zanow J, Settmacher U
Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Universitätsklinikum Jena, Erlanger Allee 101, 07743 Jena, Germany.
Chirurg. 2012 Sep;83(9):785-92. doi: 10.1007/s00104-012-2304-z.
Prosthetic arteriovenous grafts have an inferior patency rate and greater morbidity than those with autogenous vessels and are therefore considered as secondary or tertiary vascular access for hemodialysis in patients with fatigued or unsuitable superficial arm veins. Prior access planning in accordance of patient characteristics, careful operative procedure and appropriate revision of complications can ensure long-term functioning of a vascular access using a large variety of possible prosthetic conduits. Arteriovenous grafts remain essential in vascular access surgery and their role may be increasing with higher comorbidities of patients and should be preferred to tunnelled cuffed catheters. This article reviews the indications, alternative configurations and characteristics of arteriovenous grafts.
人工动静脉移植物的通畅率低于自体血管移植物，且发病率更高，因此对于浅表手臂静脉功能不佳或不适合的患者，人工动静脉移植物被视为血液透析的二级或三级血管通路。根据患者特征进行术前通路规划、谨慎的手术操作以及对并发症进行适当修正，可确保使用各种可能的人工血管 conduit 实现血管通路的长期功能。动静脉移植物在血管通路手术中仍然至关重要，随着患者合并症的增加，其作用可能会增强，并且应优先于带隧道涤纶套导管。本文综述了动静脉移植物的适应证、替代构型和特点。
