Unit of Vascular Surgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico G. Martino, University of Messina, Messina, Italy.
J Vasc Access. 2022 Jul;23(4):524-531. doi: 10.1177/11297298211002570. Epub 2021 Mar 16.
To assess and compare the maturation rate of the native radiocephalic arteriovenous fistula (RC-AVF) created with and without a nitinol external support (VasQ™ Laminate Medical Technologies Ltd, Tel Aviv, Israel).
Data of all consecutive patients who underwent the creation of native RC-AVFs at our center between October 2018 and January 2020 was prospectively collected and retrospectively analyzed.Selected patients who had a suitable vein and a radial artery with triphasic flow at preoperative duplex ultrasound exam and were selected for the creation of a radiocephalic fistula were included. Exclusion criteria were: malignant tumors, acute renal failure, previous upper limb revascularization, and septic status. Patency and maturation, vein, and artery diameter and blood flow rate were assessed at the following intervals: post-operatively, 24 h post-operatively, 1 month, 3 months, and 6 months post-operatively.
Forty-nine patients (31 males, mean age 65.7 years old) were included. Patients who received VasQ™ devices were 25 (VasQ group), the other 24 formed the control group. All patients underwent radio-cephalic AVF placement (21 on the wrist, 20 on the forearm, 8 on the proximal forearm). There were no perioperative complications and fatalities. At 1, 3, and 6 months, primary patency rates were 96 ± 4%, 96 ± 4%, 91 ± 6% (VasQ group) versus 87 ± 7%, 87 ± 7%, 80 ± 9% (control group, P 0.17), secondary patency rates were 96 ± 4%, 96 ± 4%, 91 ± 6% (VasQ group) versus 95 ± 4%, 90 ± 7%, 90 ± 7% (control group, P 0.79). A significantly larger vein diameter increase postoperatively (P 0.009) and a greater maturation rate (96% vs 74%, 0.044) were found in the VasQ group compared to the control group.
The use of the VasQ™ device was associated with higher maturation rates and larger vein diameters postoperatively. The patency rates were slightly higher but not significantly. Further studies are needed to confirm these findings.
评估并比较使用和不使用镍钛诺外部支撑（VasQ™ Laminate Medical Technologies Ltd，特拉维夫，以色列）制作原生头静脉动静脉瘘（RC-AVF）的成熟率。
我们中心于 2018 年 10 月至 2020 年 1 月期间前瞻性收集了所有连续接受原生 RC-AVF 手术的患者的数据，并进行了回顾性分析。选择在术前双功超声检查中具有合适静脉和桡动脉三相血流的患者进行头静脉瘘的制作。排除标准为：恶性肿瘤、急性肾衰竭、上肢再血管化和脓毒症状态。术后、术后 24 小时、1 个月、3 个月和 6 个月时评估通畅性和成熟度、静脉和动脉直径以及血流速度。
共纳入 49 例患者（31 例男性，平均年龄 65.7 岁）。接受 VasQ™装置的患者为 25 例（VasQ 组），其余 24 例为对照组。所有患者均接受头-腕静脉动静脉瘘（21 例在腕部，20 例在前臂，8 例在前臂近端）。围手术期无并发症和死亡。在 1、3 和 6 个月时，原发性通畅率分别为 96±4%、96±4%、91±6%（VasQ 组）和 87±7%、87±7%、80±9%（对照组，P 0.17），继发性通畅率分别为 96±4%、96±4%、91±6%（VasQ 组）和 95±4%、90±7%、90±7%（对照组，P 0.79）。VasQ 组术后静脉直径增加显著更大（P 0.009），成熟率更高（96%比 74%，0.044）。
与对照组相比，VasQ™装置的使用与更高的成熟率和术后更大的静脉直径相关。通畅率略高，但无统计学意义。需要进一步的研究来证实这些发现。
