Hatakeyama Takuya, Okamoto Hiroyuki, Nakazawa Tatsu, Nonaka Tatsuya, Sasaki Sei, Hoshino Masanobu
Division of Vascular Surgery, Seishokai Memorial Hospital, Tokyo, Japan.
Division of Vascular Surgery, Seishokai Memorial Hospital, Tokyo, Japan.
J Vasc Surg. 2017 Sep;66(3):952-957. doi: 10.1016/j.jvs.2017.03.441. Epub 2017 Jun 12.
An arteriovenous bridging graft is a viable option for patients with compromised arteries or veins because of advanced age or diabetes. Arteriovenous graft with graft insertion anastomosis (AVGI) is the novel technique for graft-vein anastomosis where the prosthesis is inserted into the vein, and the anastomosis is performed on the surface of the prosthesis. This study assessed the short-term and long-term results of AVGI to clarify the efficacy of this technique.
Between 2010 and 2015, AVGI was performed in graft-vein anastomosis of prosthetic forearm loop access. Characteristics and level of complications were assessed. To evaluate the long-term results, functional graft patency and frequency of percutaneous transluminal angioplasty were examined.
The study comprised 58 patients. There were no deaths related to the surgery. The time of hemostasis after AVGI was recorded at 0 seconds because no bleeding from the suture holes was seen. At 1, 2, and 3 years, primary patency were 45.1% ± 7.5%, 23.1% ± 7.5%, and 23.1% ± 7.5%, respectively, and assisted primary patency rates were 59.4% ± 7.2%, 50.8% ± 7.6%, and 50.8% ± 7.6%, respectively. Secondary patency rates at 4 and 5 years were 100% ± 0% and 94.1% ± 5.7%, respectively. The frequency of percutaneous balloon angioplasty to maintain the patency was 1.61 ± 0.53 times per year. Graft infection occurred in four patients (6.9%).
AVGI is an advantageous technique for graft vein anastomosis in an arteriovenous bridging graft in both the short-term and long-term.
动静脉搭桥移植术对于因高龄或糖尿病导致动静脉功能受损的患者是一种可行的选择。带移植物插入吻合术的动静脉移植物（AVGI）是一种用于移植物-静脉吻合的新技术，即把假体插入静脉，并在假体表面进行吻合。本研究评估了AVGI的短期和长期结果，以阐明该技术的疗效。
2010年至2015年期间，在人工前臂袢式通路的移植物-静脉吻合中进行了AVGI。评估并发症的特征和程度。为评估长期结果，检查了移植物的功能通畅情况和经皮腔内血管成形术的频率。
该研究纳入了58例患者。无手术相关死亡病例。由于未见缝合孔出血，AVGI术后止血时间记录为0秒。在1年、2年和3年时，初次通畅率分别为45.1%±7.5%、23.1%±7.5%和23.1%±7.5%，辅助初次通畅率分别为59.4%±7.2%、50.8%±7.6%和50.8%±7.6%。4年和5年时的二次通畅率分别为100%±0%和94.1%±5.7%。维持通畅的经皮球囊血管成形术频率为每年1.61±0.53次。4例患者（6.9%）发生了移植物感染。
AVGI在动静脉搭桥移植术中用于移植物-静脉吻合，无论短期还是长期都是一种优势技术。
