Davoudi Mahdi, Tayebi Pouya, Beheshtian Azadeh
Department of Vascular Surgery, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
J Vasc Access. 2013 Apr-Jun;14(2):111-5. doi: 10.5301/jva.5000109. Epub 2012 Oct 4.
The aim of this study was to compare the primary patency time of basilic vein transposition and prosthetic brachioaxillary access grafts in hemodialysis patients.
In this randomized clinical trial, 60 hemodialysis patients who met the inclusion/exclusion criteria were recruited and randomly assigned to two intervention groups; Basilic vein transpositions (BVT) or Arteriovenous access grafts (AVG). Clinical follow-up for patency of the created accesses in at least one year, was performed at two weeks, one, two, three months and then every three months after surgery. Finally, patency rates and access-related complications were compared in the two groups studied.
Thirty BVTs and thirty AVG were performed in each group studied. The groups were well matched for age, sex and comorbidity. After at least one year of follow-up, the access failure rate in the BVT and AVG groups was 23.3% and 30%, respectively. In addition, the mean primary patency time in the BVT and AVG groups was 244.13 ± 103.65 and 264.97 ± 149.28, respectively and there was no statistically significant difference between the two groups studied (P=.533). The common cause of access failure were thrombosis and infection but there were no statistically significant differences between the two groups (P>.05).
Our results show that AVG offer similar patency and complication rates to BVT. Thus, authors consider them as the preferred hemodialysis access when there are no suitable forearm veins to create arteriovenous fistulas.
本研究旨在比较血液透析患者中贵要静脉转位术和人工肱腋动静脉内瘘的初次通畅时间。
在这项随机临床试验中,招募了60名符合纳入/排除标准的血液透析患者,并将其随机分配到两个干预组;贵要静脉转位术(BVT)组或动静脉内瘘移植术(AVG)组。对所建立的血管通路进行至少一年的临床通畅随访,术后两周、1个月、2个月、3个月进行随访,之后每三个月随访一次。最后,比较两组的通畅率和与血管通路相关的并发症。
每组均进行了30例BVT和30例AVG手术。两组在年龄、性别和合并症方面匹配良好。经过至少一年的随访,BVT组和AVG组的血管通路失败率分别为23.3%和30%。此外,BVT组和AVG组的平均初次通畅时间分别为244.13±103.65和264.97±149.28,两组之间无统计学显著差异(P = 0.533)。血管通路失败的常见原因是血栓形成和感染,但两组之间无统计学显著差异(P>0.05)。
我们的结果表明,AVG与BVT的通畅率和并发症发生率相似。因此,作者认为在没有合适的前臂静脉来建立动静脉内瘘时,AVG是血液透析血管通路的首选。