Deguchi Juno, Sato Osamu
Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
Ann Vasc Dis. 2018 Jun 25;11(2):181-190. doi: 10.3400/avd.ra.18-00009.
As more than 320,000 patients are currently receiving hemodialysis treatment in Japan, the creation and maintenance of hemodialysis access is a major concern. The national guidelines recommend autogenous arteriovenous hemodialysis, and the brachial-basilic arteriovenous fistula has been the focus of attention, because the need for secondary, tertiary, or even more vascular access is growing. Although favorable results have been reported in terms of patency and access-related complication, this fistula involves various unsolved or controversial issues, with limitations including complex procedures, which might contribute to the lower prevalence at this point in Japan. This review addresses those issues and discusses the role of fistula in Japan.
目前在日本有超过32万名患者正在接受血液透析治疗，因此建立和维护血液透析通路是一个主要问题。国家指南推荐自体动静脉血液透析，肱动脉-贵要静脉动静脉内瘘一直是关注焦点，因为对二级、三级甚至更多血管通路的需求在不断增加。尽管在通畅率和与通路相关的并发症方面已有良好结果的报道，但这种内瘘存在各种未解决或有争议的问题，其局限性包括操作复杂，这可能是目前在日本其普及率较低的原因。本文综述讨论了这些问题，并探讨了该内瘘在日本的作用。
