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系统评价与荟萃分析:球囊血管成形术挽救未成熟动静脉内瘘的疗效与安全性

Systematic review and meta-analysis: Efficacy and safety of balloon angioplasty in salvaging non-matured arteriovenous fistulas.

作者信息

Kanchanasuttirak Pong, Pitaksantayothin Wacharaphong, Saengprakai Wuttichai, Kanchanabat Burapa

机构信息

Division of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.

出版信息

J Vasc Access. 2023 Nov;24(6):1244-1252. doi: 10.1177/11297298221085440. Epub 2022 Apr 7.

Abstract

This study aimed to evaluate the clinical and technical success rates achieved after performing balloon-assisted maturation (BAM) for non-matured arteriovenous fistula (AVF). For this, a systematic review and meta-analysis were conducted by searching PubMed and Scopus databases. Studies regarding AVFs not suitable for use based on clinical examination or ultrasound criteria and BAM use for correcting the underlying stenotic lesion were eligible for inclusion in the meta-analysis. Accordingly, 13 studies with 1427 patients with non-matured AVF who underwent BAM were included. The pooled random effect for the clinical success rate was 90% (95% CI, 86%-93%), and that for the technical success rate was 97% (95% CI, 94%-99%). Complications after BAM were reported in 1.7%-41% of the patients. Complications included venous ruptures, wall hematomas, and puncture site hematomas. Early-BAM group had better clinical success rates. BAM is an effective intervention for salvaging non-matured AVF. The procedure is safe and feasible, and high clinical and technical success rates can be achieved. The complications were also manageable without serious sequelae.

摘要

本研究旨在评估对未成熟动静脉内瘘(AVF)进行球囊辅助成熟(BAM)后的临床成功率和技术成功率。为此,通过检索PubMed和Scopus数据库进行了系统评价和荟萃分析。基于临床检查或超声标准不适合使用的AVF以及使用BAM纠正潜在狭窄病变的相关研究符合纳入荟萃分析的条件。据此,纳入了13项研究,共1427例接受BAM的未成熟AVF患者。临床成功率的合并随机效应为90%(95%CI,86%-93%),技术成功率的合并随机效应为97%(95%CI,94%-99%)。1.7%-41%的患者报告了BAM后的并发症。并发症包括静脉破裂、壁血肿和穿刺部位血肿。早期BAM组的临床成功率更高。BAM是挽救未成熟AVF的有效干预措施。该手术安全可行,可实现较高的临床成功率和技术成功率。并发症也易于处理,无严重后遗症。

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