Han Sun, Seo Pil Won, Ryu Jae-Wook
Department of Thoracic and Cardiovascular Surgery, Dankook University College of Medicine.
Korean J Thorac Cardiovasc Surg. 2017 Feb;50(1):30-35. doi: 10.5090/kjtcs.2017.50.1.30. Epub 2017 Feb 5.
Tapered grafts, which have a smaller diameter on the arterial side, have been increasingly used for arteriovenous fistula (AVF) formation. We compared the outcomes of 4-6-mm tapered and 6-mm straight forearm loop arteriovenous grafts.
A total of 103 patients receiving forearm loop arteriovenous grafts between March 2005 and March 2015 were retrospectively analyzed and separated into 2 groups (group A, 4- to 6-mm tapered grafts, n=78; group B, 6-mm straight grafts, n=25). In each group, complications and patency rates after surgery were assessed.
Clinical characteristics and laboratory results, except for cerebrovascular disease history (group A, 7.7%; group B, 28.0%; p=0.014), were similar between the groups. No significant differences were found for individual complications. Kaplan-Meier survival analysis revealed no significant differences in 1-year, 3-year, and 5-year patency rates between groups (61.8%, 44.9%, and 38.5% vs. 62.7%, 41.1%, and 35.3%, respectively).
We found no significant differences in complication and patency rates between the tapered and straight graft groups. If there are no differences in complication and patency between the two graft types, tapered grafts may be a valuable option for AVF formation in light of their other advantages.
动脉侧直径较小的锥形移植物越来越多地用于动静脉内瘘（AVF）的形成。我们比较了4 - 6毫米锥形和6毫米直形前臂袢动静脉移植物的效果。
回顾性分析2005年3月至2015年3月期间接受前臂袢动静脉移植物的103例患者，并将其分为2组（A组，4 - 6毫米锥形移植物，n = 78；B组，6毫米直形移植物，n = 25）。评估每组手术后的并发症和通畅率。
除脑血管疾病史外（A组，7.7%；B组，28.0%；p = 0.014），两组间的临床特征和实验室结果相似。个体并发症方面未发现显著差异。Kaplan - Meier生存分析显示两组间1年、3年和5年通畅率无显著差异（分别为61.8%、44.9%和38.5% 对比 62.7%、41.1%和35.3%）。
我们发现锥形移植物组和直形移植物组在并发症和通畅率方面无显著差异。如果两种移植物在并发症和通畅方面没有差异，鉴于其其他优势，锥形移植物可能是AVF形成的一个有价值的选择。
