University of Ottawa, Ottawa, ON, K1N6N5, Canada.
Division of Vascular and Endovascular Surgery, Department of Surgery, The Ottawa Hospital - Civic Campus, Ottawa, ON, K1Y4E9, Canada.
Syst Rev. 2020 Aug 21;9(1):193. doi: 10.1186/s13643-020-01435-1.
Arteriovenous (AV) hemodialysis access creation is recommended by international guidelines as the preferred method of hemodialysis access. However, most AV access sites will require revision to maintain patency. Although several treatment options exist, many have not been directly compared. We intend to compare the relative effectiveness of methods to maintain post-intervention primary patency of failing AV access.
We will search EMBASE, MEDLINE, CENTRAL, trial registries, the grey literature, and ancestry and citation search from January 1977 to present, for randomized controlled trials comparing interventions to maintain primary patency of AV access. Two investigators will independently and blindly review all identified citations and extract data from included studies. The primary outcome is the primary patency 6 months after intervention. Secondary outcomes include immediate technical and functional success, reinterventions, patency, and mortality. Risk of bias, subgroup analyses, and sensitivity analyses are planned.
There are a number of treatment modalities for the management of failing AV access. However, most modalities have only been directly compared with plain old balloon angioplasty, and currently synthesized evidence focuses on individual pairwise comparisons. In light of the lack of comprehensively synthesized evidence and clinical equipoise, our study intends to synthesize currently available evidence though it is unclear which treatment modality is most effective.
PROSPERO ID CRD42020148224.
国际指南建议动静脉（AV）血液透析通路的建立作为血液透析通路的首选方法。然而，大多数 AV 通路都需要进行修改以保持通畅。尽管有几种治疗选择，但许多选择尚未进行直接比较。我们旨在比较维持失功 AV 通路术后一期通畅的各种方法的相对有效性。
我们将从 1977 年 1 月到现在，在 EMBASE、MEDLINE、CENTRAL、试验登记处、灰色文献以及追溯和引文搜索中，检索比较干预措施以维持 AV 通路一期通畅的随机对照试验。两名调查员将独立地、盲法地对所有识别出的参考文献进行审查，并从纳入的研究中提取数据。主要结局是干预后 6 个月的一期通畅率。次要结局包括即刻技术和功能成功率、再干预、通畅率和死亡率。计划进行偏倚风险、亚组分析和敏感性分析。
有许多治疗方法可用于管理失功的 AV 通路。然而，大多数方法仅与传统的单纯球囊血管成形术进行了直接比较，而目前综合证据主要集中在个体的两两比较上。鉴于缺乏全面综合的证据和临床均衡性，我们的研究旨在通过综合目前可用的证据来解决这一问题，但尚不清楚哪种治疗方法最有效。
PROSPERO 注册号 CRD42020148224。
