Park Sun Cheol, Ko Seung Yeon, Kim Ji Il, Moon In Sung, Kim Sang Dong
Division of Vascular and Transplant Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Ann Surg Treat Res. 2016 May;90(5):272-8. doi: 10.4174/astr.2016.90.5.272. Epub 2016 May 2.
Balloon-assisted maturation (BAM) is emerging as a salvage management for arteriovenous fistula maturation failure (AVF MF). However, BAM is a relatively new, yet controversial technique for AVF maturation. Therefore, we evaluated the effectiveness of BAM for AVF MF.
Between January 2012 and December 2014, 249 AVFs were created. The total MF rate was 24.8%. But, only 110 AVFs were enrolled, including 74 brachiocephalic (BC) AVFs and 36 radiocephalic (RC) AVFs. The follow-up period was 12 months. Among those, there were 42 MFs (22 BC AVFs and 20 RC AVFs) and 68 maturation successes (MS) (52 BC AVFs and 16 RC AVFs). BAM was involved in MF group. We compared the clinical characteristics, AVF flows, and AVF flow ratios of MF and MS groups. Also, we evaluated the etiology, management, and result of MF.
There was no difference in clinical characteristics between MF and MS groups. In MF group, 39 balloon angioplasties (BAs) for 42 AVF MFs were performed. Number of BA was 1.45 ± 0.57 and duration of BA was 21.30 ± 21.24 weeks. BAM rate was 46.2%. For 1 year after AVF creation, AVF flows of MS group were significantly larger than those of MF group (P < 0.05) but there was no difference in AVF flow ratio between MF and MS groups (P > 0.05).
BA for AVF MF is a relatively applicable and effective modality. Although a large volume study is necessary, we suggest BAM is an effective salvage management for AVF MF.
球囊辅助成熟术（BAM）正逐渐成为动静脉内瘘成熟失败（AVF MF）的一种挽救性治疗方法。然而，BAM对于AVF成熟来说是一种相对较新但存在争议的技术。因此，我们评估了BAM治疗AVF MF的有效性。
在2012年1月至2014年12月期间，共创建了249个AVF。总的成熟失败率为24.8%。但仅纳入了110个AVF，其中包括74个头臂型（BC）AVF和36个桡动脉-头静脉型（RC）AVF。随访期为12个月。其中，有42个成熟失败（MF）（22个BC AVF和20个RC AVF）以及68个成熟成功（MS）（52个BC AVF和16个RC AVF）。MF组采用了BAM。我们比较了MF组和MS组的临床特征、AVF血流量以及AVF血流比率。此外，我们评估了MF的病因、治疗方法及结果。
MF组和MS组的临床特征无差异。在MF组中，对42个AVF MF进行了39次球囊血管成形术（BA）。BA次数为1.45±0.57，BA持续时间为21.30±21.24周。BAM率为46.2%。在AVF创建后的1年里，MS组的AVF血流量显著大于MF组（P<0.05），但MF组和MS组之间的AVF血流比率无差异（P>0.05）。
用于AVF MF的BA是一种相对适用且有效的治疗方式。尽管有必要进行大规模研究，但我们认为BAM是治疗AVF MF的一种有效挽救性治疗方法。
