Hon Prof of Surgery, Univeristy of Glasgow, UK.
Department of Vascular Surgery, Queen Elizabeth University Hospital, Glasgow, UK.
J Vasc Access. 2023 Sep;24(5):873-878. doi: 10.1177/11297298211055611. Epub 2021 Nov 11.
Guidelines make no firm recommendations about surveillance of arteriovenous grafts as several randomised trials (RCT) have not shown a clear benefit in patency. However a more thorough review of these RCT based on epidemiological principles reveals significant limitations. In particular a key weakness of these older studies is the interventions performed for venous stenosis detected that was largely angioplasty. However, the observational data of modern stent-grafts shows a clear benefit over angioplasty, and thus seems to suggest that a modern well considered RCT is now mandated.
指南并未对动静脉移植物的监测提出明确建议，因为几项随机对照试验（RCT）并未显示在通畅性方面有明显获益。然而，根据流行病学原理对这些 RCT 进行更全面的审查揭示了其存在显著局限性。特别是这些早期研究的一个关键弱点是针对检测到的静脉狭窄所进行的干预措施，主要是血管成形术。然而，现代支架移植物的观察数据显示其在血管成形术方面具有明显获益，因此似乎表明现在需要进行一项精心设计的现代 RCT。
