血栓形成的自体动静脉内瘘的药物机械干预与手术干预的比较
Comparison of pharmacomechanical and surgical interventions for thrombosed native arteriovenous fistulas.
作者信息
Aydın Ebuzer, Bademci Mehmet Şenel, Kocaaslan Cemal
机构信息
Department of Cardiovascular Surgery, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey.
出版信息
Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Oct 21;28(4):609-614. doi: 10.5606/tgkdc.dergisi.2020.19565. eCollection 2020 Oct.
BACKGROUND
This study aims to compare success and patency rates of pharmacomechanical thrombectomy versus open surgical thrombectomy for thrombosed native arteriovenous fistulas.
METHODS
A total of 96 patients (56 males, 40 females; mean age 61±11.7 years; range, 26 to 82 years) with a thrombosed native arteriovenous fistula between January 2016 and December 2018 were retrospectively analyzed. The patients were divided into two groups as pharmacomechanical thrombectomy (n=42) and open surgical thrombectomy (n=54). Primary failure rate and primary patency rate at 6 and 12 months were recorded.
RESULTS
Of 42 patients in the pharmacomechanical thrombectomy group, 41 (98%) had additional interventions, and primary failure occurred in four patients (10%). Primary failure was seen in 15 (28%) patients in the surgical group. The primary patency rates at 6 and 12 months were significantly higher in the pharmacomechanical treatment group than the surgical group (85% vs. 67% and 78% vs. 55%, respectively; p<0.05).
CONCLUSION
Pharmacomechanical thrombectomy procedure yields higher primary patency rates than open surgical thrombectomy for thrombosed native arteriovenous fistula.
背景
本研究旨在比较药物机械性血栓切除术与开放性手术血栓切除术治疗自体动静脉内瘘血栓形成的成功率和通畅率。
方法
回顾性分析2016年1月至2018年12月期间96例自体动静脉内瘘血栓形成患者（男性56例，女性40例；平均年龄61±11.7岁；范围26至82岁）。患者分为两组，即药物机械性血栓切除术组（n = 42）和开放性手术血栓切除术组（n = 54）。记录6个月和12个月时的初次失败率和初次通畅率。
结果
在药物机械性血栓切除术组的42例患者中，41例（98%）接受了额外干预，4例患者（10%）出现初次失败。手术组有15例（28%）患者出现初次失败。药物机械性治疗组6个月和12个月时的初次通畅率显著高于手术组（分别为85%对67%和78%对55%；p<0.05）。
结论
对于自体动静脉内瘘血栓形成，药物机械性血栓切除术的初次通畅率高于开放性手术血栓切除术。
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