de Castro-Santos Guilherme, Salles Alberto Gualter, Dos Anjos Giuliano Silva, Procópio Ricardo Jayme, Navarro Túlio Pinho
Universidade Federal de Minais Gerais - UFMG, Faculdade de Medicina, Departamento de Cirurgia, Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais - UFMG, Hospital das Clínicas, Serviço de Cirurgia Vascular, Belo Horizonte, MG, Brasil.
J Vasc Bras. 2019 Nov 18;18:e20190077. doi: 10.1590/1677-5449.190077.
There is currently a worldwide effort to increase the options for autogenous hemodialysis access.
To evaluate patency and complications of brachial vein transposition compared to other autogenous hemodialysis accesses.
A retrospective evaluation of 43 patients and 45 procedures. Patients who did not have adequate superficial veins according to duplex scanning were allocated to brachial vein transposition. The sample was thus divided in two groups, as follows: A: brachial vein transposition n=10 and B: other autogenous accesses n=35.
There were no statistical differences between the two groups in terms of age diabetes, systemic arterial hypertension, dyslipidemias, arteriopathies, neoplasms, kidney disease stage, donor artery diameter, recipient vein diameter, systolic blood pressure in the operated limb, postoperative ischemia, hematoma, or infection. There were no statistical differences in terms of patency on day 7: A 80% vs. B 90% p=0.6, on day 30: A 80% vs. B 86% p=0.6, or on day 60: A 60% vs. B 80% p=0.22. There were statistical differences between the groups for number of previous fistulae A 1.0 ± 0.44 vs. B 0.6 ± 0.3 p = 0.04 and upper limb edema A: 20% x B 0% p = 0.04. A vein with diameter of less than 3 mm was associated with an increased risk of early occlusion (RR = 8 p = 0.0125). During the study period there were no procedures using grafts.
Transposition of brachial vein is an alternative to arteriovenous graft.
目前全球都在努力增加自体血液透析通路的选择。
评估肱静脉转位术与其他自体血液透析通路相比的通畅率和并发症情况。
对43例患者和45例手术进行回顾性评估。根据双功超声扫描，没有足够浅表静脉的患者被分配接受肱静脉转位术。样本因此分为两组，如下：A组：肱静脉转位术n = 10；B组：其他自体通路n = 35。
两组在年龄、糖尿病、系统性动脉高血压、血脂异常、动脉病变、肿瘤、肾病分期、供体动脉直径、受体静脉直径、手术肢体的收缩压、术后缺血、血肿或感染方面无统计学差异。在第7天的通畅率方面无统计学差异：A组80% vs. B组90%，p = 0.6；在第30天：A组80% vs. B组86%，p = 0.6；或在第60天：A组60% vs. B组80%，p = 0.22。两组在前次造瘘数量上有统计学差异，A组1.0 ± 0.44 vs. B组0.6 ± 0.3，p = 0.04；上肢水肿方面也有差异，A组20% vs. B组0%，p = 0.04。直径小于3mm的静脉与早期闭塞风险增加相关（RR = 8，p = 0.0125）。在研究期间没有使用移植物的手术。
肱静脉转位术是动静脉移植物的一种替代方法。
