Department of Vascular Surgery, Aswan University Hospital, Aswan, Egypt.
Department of Vascular Surgery, Derriford Hospital, Plymouth, United Kingdom.
Pan Afr Med J. 2021 Dec 21;40:245. doi: 10.11604/pamj.2021.40.245.29390. eCollection 2021.
Vascular access failure causes significant morbidity among end stage renal failure patients. With the increased life expectancy and frailty of those patients, maintaining vascular access became a great challenge. In this study, we assess the short and midterm outcomes of infraclavicular arterio-arterial prosthetic loop (IAAPL) as vascular access for haemodialysis in frail patients who have exhausted conventional vascular access methods. A prospective observational study of 43 patients undergoing IAAPL was conducted in a single centre between May 2017 and March 2020. Primary, assisted primary and secondary patency rates were recorded in addition to complications and patient compliance with access. The achieved primary, assisted primary and secondary patency rates at 6 months are 87.5%, 95%, 97.5% respectively, at one year, corresponding rates were 75%, 83.3%, 94.4% and at 18 months they were 68.6%, 77.1%, 85.7% respectively. There was no procedure related mortality and life-threatening complications during the study period. So we can assume that infraclavicular AAPL is a safe and effective method of obtaining alternative vascular access for hemodialysis in frail patients for whom the conventional vascular access for hemodialysis is not suitable or contraindicated.
血管通路失败会导致终末期肾衰竭患者出现严重的发病率。随着这些患者预期寿命的延长和身体虚弱，维持血管通路成为一项巨大的挑战。在这项研究中，我们评估了锁骨下动脉-动脉人工环（IAAPL）作为血管通路在那些已经用尽常规血管通路方法的虚弱患者中的短期和中期结果。在 2017 年 5 月至 2020 年 3 月期间，在一个中心进行了一项针对 43 名接受 IAAPL 的患者的前瞻性观察研究。除了并发症和患者对通路的依从性外，还记录了主要、辅助主要和次要通畅率。6 个月时的主要、辅助主要和次要通畅率分别为 87.5%、95%、97.5%，1 年时分别为 75%、83.3%、94.4%，18 个月时分别为 68.6%、77.1%、85.7%。在研究期间，没有与手术相关的死亡和危及生命的并发症。因此，我们可以假设锁骨下 AAPL 是一种安全有效的方法，可为不适合或禁忌常规血液透析血管通路的虚弱患者提供替代血液透析血管通路。
