血管内支架移植物治疗动静脉内瘘透析患者的移植静脉吻合口狭窄
Endovascular stent-graft treatment for graft-vein anastomotic stenosis in haemodialysis patients with arteriovenous grafts.
作者信息
Lin Chia-Hsun, Chen Yen-Yang, Chua Chai-Hock, Lu Ming-Jen
机构信息
1 Division of Cardiovascular Surgery, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
出版信息
Vasa. 2015 Nov;44(6):466-72. doi: 10.1024/0301-1526/a000470.
BACKGROUND
In this study, we investigated the patency of endovascular stent grafts in haemodialysis patients with arteriovenous grafts, the modes of patency loss, and the risk factors for re-intervention.
PATIENTS AND METHODS
Haemodialysis patients with graft-vein anastomotic stenosis of their arteriovenous grafts who were treated with endovascular stent-grafts between 2008 and 2013 were entered into this retrospective study. Primary and secondary patency, modes of patency loss, and risk factors for intervention were recorded.
RESULTS
Cumulative circuit primary patency rates decreased from 40.0% at 6 months to 7.3% at 24 months. Cumulative target lesion primary patency rates decreased from 72.1% at 6 months to 22.0% at 24 months. Cumulative secondary patency rates decreased from 81.3% at 12 months to 31.6% at 36 months. Patients with a history of cerebrovascular accident had a significantly higher risk of secondary patency loss, and graft puncture site stenosis jeopardised the results of stent-graft treatment.
CONCLUSIONS
Our data can help to improve outcomes in haemodialysis patients treated with stent-grafts for venous anastomosis of an arteriovenous graft.
背景
在本研究中，我们调查了血管内支架移植物在动静脉内瘘血液透析患者中的通畅情况、通畅性丧失的模式以及再次干预的危险因素。
患者与方法
对2008年至2013年间接受血管内支架移植物治疗的动静脉内瘘出现移植静脉吻合口狭窄的血液透析患者进行了这项回顾性研究。记录了初次和二次通畅率、通畅性丧失的模式以及干预的危险因素。
结果
累计通路初次通畅率从6个月时的40.0%降至24个月时的7.3%。累计靶病变初次通畅率从6个月时的72.1%降至24个月时的22.0%。累计二次通畅率从12个月时的81.3%降至36个月时的31.6%。有脑血管意外病史的患者二次通畅性丧失的风险显著更高，且移植物穿刺部位狭窄会危及支架移植物治疗的效果。
结论
我们的数据有助于改善接受支架移植物治疗动静脉内瘘静脉吻合的血液透析患者的治疗效果。
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