辅助静脉闭塞和球囊辅助成熟在血液透析中用于未成熟动静脉瘘：系统评价和荟萃分析。
Accessory Vein Obliteration and Balloon-Assisted Maturation for Immature Arteriovenous Fistulas for Haemodialysis: A Systematic Review and Meta-Analysis.
机构信息
Duke-NUS Medical School, Singapore, 169857, Singapore.
Yong Loo Lin School of Medicine, Singapore, 117597, Singapore.
出版信息
Cardiovasc Intervent Radiol. 2022 Oct;45(10):1415-1427. doi: 10.1007/s00270-022-03212-0. Epub 2022 Jul 19.
PURPOSE
This study aims to examine outcomes of immature arteriovenous fistula salvage using balloon angioplasty (PTA) without and with accessory vein obliteration (PTA + VO).
MATERIALS AND METHODS
PubMed and Embase were accessed on 21 September 2020 to retrieve cohort studies on adult patients with end-stage renal failure (ESRF) requiring dialysis. Risk of bias was assessed using Newcastle-Ottawa Scale. Studies were pooled into PTA or PTA + VO arms, with outcomes (technical/clinical success, primary/secondary post-intervention patency until 12 months) reported as event rates with 95% confidence intervals. Random-effects model and maximum likelihood meta-regression were used for meta-analysis.
RESULTS
Fourteen studies (1030 participants) were included. The between-subgroup difference in outcomes was largely non-significant (p > 0.050).
CONCLUSION
The evidence does not support balloon angioplasty with concomitant accessory vein obliteration for immature fistula salvage.
目的
本研究旨在探讨单纯球囊血管成形术（PTA）与球囊血管成形术联合辅助静脉闭塞术（PTA+VO）治疗未成熟动静脉瘘的疗效。
材料与方法
2020 年 9 月 21 日，检索 PubMed 和 Embase 数据库，纳入需要透析的终末期肾病（ESRF）成年患者的队列研究。采用 Newcastle-Ottawa Scale 评估偏倚风险。研究分为 PTA 或 PTA+VO 组，以事件发生率及其 95%置信区间报告技术/临床成功率、主要/次要干预后 12 个月内的通畅率等结局。采用随机效应模型和最大似然法进行荟萃分析。
结果
纳入 14 项研究（共 1030 名患者）。组间差异大多无统计学意义（p＞0.050）。
结论
目前证据不支持球囊血管成形术联合辅助静脉闭塞术治疗未成熟动静脉瘘。
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