Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, Taiwan.
Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, Taiwan.
J Vasc Surg. 2022 Oct;76(4):1060-1065. doi: 10.1016/j.jvs.2022.04.037. Epub 2022 Jun 11.
Balloon-assisted maturation (BAM) by an endovascular method plays an important role in treating an immature arteriovenous fistula. However, the results between radiocephalic fistula and brachiocephalic fistula were rarely reported. This retrospective study aimed to investigate the effectiveness and outcome of BAM in different sites of autogenous arteriovenous fistulas.
This single-center retrospective study included patients who underwent BAM procedures from January 2015 to December 2016. Of 148 patients, 117 and 31 patients had a radiocephalic fistula (RC) and a brachiocephalic fistula (BC), respectively. The primary outcome was BAM success. Data regarding fistula lesions, balloon types and size, frequency of procedures, and maturation time were collected for BAMs. The secondary outcome was the patency of a fistula in the follow-up period.
No difference was observed in procedure of BAM frequency between the RC and BC groups. The total success rate was 77.7%, without significant difference between the RC and BC groups (81.20% vs 64.50%; P = .055). Within the procedures, the culprit lesion of juxta-anastomosis segment (73.5% vs 25.5%; P < .001) and arterial inlet (21.2% vs 7.8%; P = .04) were more common in the RC group, whereas the venous outlet was more common in the BC group (88.2% vs 57.7%; P < .001). Both groups had an equivalent patency rate after the BAM within the follow-up period (P = .272).
BAM was an effective procedure for immature fistulas, without significant difference between RCs and BCs. Through the procedure, the culprit lesions causing non-maturation were found to be different between the two groups. The patency rate between the two groups after surgery seems to be equivalent within the follow-up period.
经血管腔内方法的球囊辅助成熟（BAM）在治疗不成熟动静脉瘘中发挥重要作用。然而，桡动脉-头静脉瘘和肱动脉-头静脉瘘之间的结果很少有报道。本回顾性研究旨在探讨不同部位自体动静脉瘘行 BAM 的效果和结局。
这项单中心回顾性研究纳入了 2015 年 1 月至 2016 年 12 月期间接受 BAM 治疗的患者。148 例患者中，桡动脉-头静脉瘘（RC）组 117 例，肱动脉-头静脉瘘（BC）组 31 例。主要结局为 BAM 成功。收集 BAM 相关的瘘管病变、球囊类型和大小、手术次数和成熟时间的数据。次要结局为随访期间瘘管通畅情况。
RC 组和 BC 组 BAM 手术次数无差异。总成功率为 77.7%，RC 组和 BC 组之间无显著差异（81.20% vs 64.50%；P=0.055）。在手术过程中，吻合口近段病变（73.5% vs 25.5%；P<0.001）和动脉入口（21.2% vs 7.8%；P=0.04）在 RC 组更为常见，而静脉出口在 BC 组更为常见（88.2% vs 57.7%；P<0.001）。在随访期间，两组 BAM 后的通畅率相当（P=0.272）。
BAM 是治疗不成熟瘘管的有效方法，RC 组和 BC 组之间无显著差异。通过该手术，发现两组导致不成熟的病变部位不同。在随访期间，两组术后的通畅率似乎相当。
