Palumbo Roberto, Dominijanni Sara, Centi Alessia, D'Urso Gabriele, Tatangelo Paola, Floccari Fulvio, Smedile Gianluca, Niscola Pasquale, Londrino Francesco, Di Daniele Nicola
Nephrology Unit, ASL Roma2, Saint'Eugenio Hospital, Rome, Italy.
Haematology Unit, ASL Roma2, Saint 'Eugenio Hospital, Rome, Italy.
J Vasc Access. 2022 Jan;23(1):105-108. doi: 10.1177/1129729820983153. Epub 2020 Dec 21.
Native arteriovenous fistula is the preferred vascular access in term of functionality, efficiency and complication rate. Nevertheless, research continues to seek strategies to reduce the risk of neointimal hyperplasia and hemodynamic modification. The aim of the study was to evaluate the impact on hemodynamic of the VasQ device in arteriovenous fistulae creation.
The analysis included patients who underwent to fistula creation with or without implantation of the VasQ device between May and September 2019. The hemodynamic parameters were evaluated pre-operatively and at a follow-up of 1, 3, 6 months. The patency and complication rate were evaluated.
Fifteen VasQ devices were implanted during 30 arteriovenous fistula surgery. The baseline patients features were similar between groups (VasQ treated/control). At baseline, preoperative arterial flow was similar; radial artery diameter at surgical site was 3.4 ± 0.8 mm in treated and 2.8 ± 0.5 mm in the control group. The mean arterial flow at 1 month was 480 ± 210 mL/min in treated and 561 ± 27 mL/min in the control group. At 3 months the mean arterial flow in treated was 645 ± 143 mL/min versus 824 ± 211 mL/min ( = 0.02) in the control group; at 6 months the arterial flow was 714 ± 146 mL/min versus 810 ± 194 mL/min ( = 0.05) in control group. The cardiac output flow at 6 months in the treated group was 4458 ± 928 mL/min versus 5599 ± 1355 mL/min ( = 0.05) in the control group. At 6 months the primary patency was 73% and 80% and the secondary patency 80% and 86% in treated compared to the control group, respectively. No VASQ device complications were recorded.
The analysis of these data suggested that using VasQ device could be protective against the hemodynamic modification that occur during arteriovenous fistulae creation.
就功能、效率和并发症发生率而言，自体动静脉内瘘是首选的血管通路。然而，研究仍在继续寻找降低内膜增生和血流动力学改变风险的策略。本研究的目的是评估VasQ装置在动静脉内瘘创建中对血流动力学的影响。
分析纳入了2019年5月至9月期间接受动静脉内瘘创建手术（无论是否植入VasQ装置）的患者。在术前以及术后1、3、6个月的随访中评估血流动力学参数。评估通畅率和并发症发生率。
在30例动静脉内瘘手术中植入了15个VasQ装置。两组（VasQ治疗组/对照组）患者的基线特征相似。基线时，术前动脉血流相似；手术部位的桡动脉直径在治疗组为3.4±0.8mm，在对照组为2.8±0.5mm。治疗组1个月时的平均动脉血流为480±210mL/min，对照组为561±27mL/min。3个月时，治疗组的平均动脉血流为645±143mL/min，对照组为824±211mL/min（P=0.02）；6个月时，动脉血流分别为714±146mL/min和810±194mL/min（P=0.05）。治疗组6个月时的心输出量为4458±928mL/min，对照组为5599±1355mL/min（P=0.05）。6个月时，治疗组的初级通畅率分别为73%和80%，次级通畅率分别为80%和86%，而对照组分别为80%和86%。未记录到VASQ装置并发症。
对这些数据的分析表明，使用VasQ装置可能有助于预防动静脉内瘘创建过程中发生的血流动力学改变。
