Liu Wing, Lagaac Regin, Pettigrew Gavin J, Callaghan Christopher J
University Department of Surgery, Addenbrooke's Hospital, NIHR Comprehensive Biomedical Research Centre, Cambridge, UK.
Ann Vasc Surg. 2013 Feb;27(2):232-7. doi: 10.1016/j.avsg.2012.04.014. Epub 2012 Sep 12.
The ulnar-basilic arteriovenous fistula (UBAVF) is rarely used owing to perceived problems with poor patency and prolonged maturation times. We report outcomes after UBAVF formation.
Patients who had a forearm UBAVF formed between October 1, 2002 and September 31, 2010 were identified from a prospectively maintained database.
Fifty-two UBAVFs were formed in 48 patients. The majority were male (77.1%), with a median (range) age of 69.5 (18-86) years. Primary and secondary patencies at 1, 3, and 5 years were 43%, 13%, 13%, and 54%, 18%, and 13%, respectively. Primary patencies were higher in those with previously functioning radiocephalic arteriovenous fistulas on the same arm (P = 0.03). Thirty-six percent of UBAVFs became functional, with a median (range) time to maturation of 100 (32-471) days. Nine UBAVFs (17.3%) required revision surgery. Complications were rare (7.7%), with only one case of steal syndrome.
Although UBAVF patency and functionality rates are low, we believe that these are acceptable, given the low risk of complications and preservation of precious upper-arm venous capital. Maturation can be prolonged, but when the forearm cephalic vein is unusable, UBAVFs can provide an alternative to upper-arm fistulas, and should be utilized more widely, especially in those with previously functioning ipsilateral radiocephalic arteriovenous fistulas.
由于存在通畅性差和成熟时间延长等问题，尺侧-贵要动静脉内瘘（UBAVF）很少被使用。我们报告了UBAVF形成后的结果。
从一个前瞻性维护的数据库中识别出2002年10月1日至2010年9月31日期间形成前臂UBAVF的患者。
48例患者共形成了52个UBAVF。大多数为男性（77.1%），中位（范围）年龄为69.5（18 - 86）岁。1年、3年和5年的初级和次级通畅率分别为43%、13%、13%和54%、18%、13%。同一只手臂上先前有功能的桡动脉-头静脉内瘘的患者，其初级通畅率更高（P = 0.03）。36%的UBAVF开始发挥功能，中位（范围）成熟时间为100（32 - 471）天。9个UBAVF（17.3%）需要进行翻修手术。并发症很少见（7.7%），仅1例出现窃血综合征。
尽管UBAVF的通畅率和功能率较低，但考虑到并发症风险低且保留了珍贵的上臂静脉资源，我们认为这些是可以接受的。成熟时间可能会延长，但当前臂头静脉不可用时，UBAVF可为上臂内瘘提供一种替代方案，应更广泛地应用，尤其是在那些先前同侧有功能的桡动脉-头静脉内瘘的患者中。
