Yilmazsoy Yunus, Ozyer Umut
1 Department of Radiology, Bolu State Hospital, Bolu, Turkey.
2 Department of Radiology, Faculty of Medicine, Baskent University, Ankara, Turkey.
J Vasc Access. 2019 Sep;20(5):545-552. doi: 10.1177/1129729819865808. Epub 2019 Aug 3.
This study aimed to determine the long-term patency duration and rate of thrombosis of autologous arteriovenous fistulas and synthetic grafts treated with endovascular methods in a large patient population.
A total of 144 arteriovenous accesses (37 radiocephalic, 51 brachiobasilic, 41 brachiocephalic, and 15 femorofemoral) from 143 patients were included in the study. A total of 304 endovascular thrombolytic treatment procedures were performed for 94 (65%) arteriovenous fistula and 50 (35%) arteriovenous graft accesses.
The procedural technical success rate was 98.7%. The mean follow-up duration was 32.5 (range, 3-132) months. The primary patency rates for arteriovenous fistulas and arteriovenous grafts were 78% and 78% at 6 months, 66% and 63% at 1 year, and 45% and 0% at 36 months, respectively. The assisted primary patency rates for arteriovenous fistulas and arteriovenous grafts were 82% and 84% at 6 months, 71% and 69% at 1 year, 51% and 29% at 36 months, and 30% and 1% at 60 months, respectively. The secondary patency rates for arteriovenous fistulas and arteriovenous grafts were 94% and 93% at 6 months, 85% and 85% at 1 year, 58% and 59% at 36 months, and 47% and 48% at 60 months, respectively.
Although the primary patency durations for arteriovenous fistulas were better after endovascular thrombolytic treatment than those for arteriovenous grafts, the long-term outcomes of assisted primary and secondary patency durations after repeated procedures were similar for both types of arteriovenous accesses.
本研究旨在确定在大量患者群体中，采用血管内治疗方法的自体动静脉内瘘和人工血管移植物的长期通畅持续时间和血栓形成率。
本研究纳入了143例患者的总共144处动静脉通路（37处桡动脉-头静脉、51处肱动脉-尺静脉、41处肱动脉-头静脉和15处股动脉-股静脉）。对94处（65%）动静脉内瘘和50处（35%）动静脉移植物通路共进行了304次血管内溶栓治疗操作。
手术技术成功率为98.7%。平均随访时间为32.5（范围3 - 132）个月。动静脉内瘘和动静脉移植物的初次通畅率在6个月时分别为78%和78%，1年时分别为66%和63%，36个月时分别为45%和0%。动静脉内瘘和动静脉移植物的辅助初次通畅率在6个月时分别为82%和84%，1年时分别为71%和69%，36个月时分别为51%和29%，60个月时分别为30%和1%。动静脉内瘘和动静脉移植物的二次通畅率在6个月时分别为94%和93%，1年时分别为85%和85%，36个月时分别为58%和59%，60个月时分别为47%和48%。
尽管血管内溶栓治疗后动静脉内瘘的初次通畅持续时间优于动静脉移植物，但对于这两种类型的动静脉通路，重复操作后的辅助初次和二次通畅持续时间的长期结果相似。
