Department of Ultrasonography, Yongchuan Hospital of Chongqing Medical University, Chongqing, China.
Leshan Hospital of Traditional Chinese Medicinel, Leshan, China.
Blood Purif. 2022;51(12):1031-1038. doi: 10.1159/000524159. Epub 2022 May 3.
This study aimed to analyse the influencing factors of arteriovenous fistula (AVF) ultrasound-guided restenosis after percutaneous transluminal angioplasty (PTA).
This was a retrospective trial. The clinical data and ultrasound examination data of patients in maintenance haemodialysis who received ultrasound-guided PTA for AVF stenosis at our hospital from January 2018 to December 2020 were retrospectively analysed. The fistula patency and the relationship between age, dialysis age, fistula service age, combined hypertension, diabetes, hypoproteinaemia, stenosis type, fistula location, and patency rate after the operation were evaluated.
A total of 128 participants were evaluated. The results showed that being over 65 years old, with complications from hypertension, diabetes, and hypoproteinaemia, are all risk factors affecting the patency of postoperative internal fistulas. Compared with lumen stenosis, the patency rate of hyperplastic endothelial stenosis (p = 0.014) and thrombotic stenosis (p = 0.017) was lower, and the difference was statistically significant. The patency rate of the mixed site (p = 0.010), the anastomotic site (p = 0.041), and the cephalic vein near the anastomotic site (p = 0.018) was lower than the forearm cephalic vein, and the difference was statistically significant.
Age, hypertension complications, diabetes complications, hypoproteinaemia, and the type and location of the AVF stenosis were essential for vascular patency of internal fistulas after PTA. Other risk factors of restenosis after PTA still need further research.
本研究旨在分析经皮腔内血管成形术(PTA)后动静脉瘘(AVF)超声引导下再狭窄的影响因素。
这是一项回顾性试验。回顾性分析 2018 年 1 月至 2020 年 12 月在我院接受超声引导下 PTA 治疗 AVF 狭窄的维持性血液透析患者的临床资料和超声检查资料。评估瘘管通畅性及年龄、透析年龄、瘘管使用年龄、合并高血压、糖尿病、低蛋白血症、狭窄类型、瘘管位置与术后通畅率的关系。
共 128 例患者进行了评估。结果显示,年龄大于 65 岁、合并高血压、糖尿病、低蛋白血症是影响术后内瘘通畅的危险因素。与管腔狭窄相比,增生性内皮狭窄(p = 0.014)和血栓性狭窄(p = 0.017)的通畅率较低,差异有统计学意义。混合部位(p = 0.010)、吻合口部位(p = 0.041)和吻合口附近头静脉(p = 0.018)的通畅率低于前臂头静脉,差异有统计学意义。
年龄、高血压并发症、糖尿病并发症、低蛋白血症以及 AVF 狭窄的类型和位置是影响 PTA 后内瘘血管通畅的重要因素。PTA 后再狭窄的其他危险因素仍需进一步研究。