Department of Vascular Surgery, Bousei Daiichi Clinic, Numazu-shi, Shizuoka, Japan.
Department of Nephrology, Bousei Daiichi Clinic, Numazu-shi, Shizuoka, Japan.
J Vasc Access. 2024 May;25(3):800-807. doi: 10.1177/11297298221127752. Epub 2022 Oct 6.
We have previously evaluated the usefulness of venocutaneous fistula (VCF), also called "dermatorrhea." VCF is a technique of blood removal/return by advancing a dialysis cannula to the femoral vein for each hemodialysis session using a fistula created between the great saphenous vein and skin.
In this study, we evaluated 46 limbs of 40 patients for whom VCF was created at our hospital between May 2017 and April 2022. In all the patients, it was difficult to construct an arteriovenous fistula or arteriovenous graft because of the general/vascular conditions. The usefulness of this method was evaluated based on the results of dialysis treatment after fistula creation and the use of fistula.
Fundamental evaluation confirmed the progression of vascular wall thickening over time. During clinical review, no serious complications were found in any patient during or after fistula creation surgery. The infection rate was 0.30/1000 days of fistula maintenance. Secondary patency rates by the Kaplan-Meier method were 87.0% at 1 year and 42.6% at 3 years.
This method has demonstrated a good patency rate, low infection rate, and seems to be a potentially useful alternative in patients in whom it is difficult to establish vascular access.
我们之前评估过动静脉瘘（VCF），也称为“皮肤漏”的有用性。VCF 是一种通过在每次血液透析时将透析套管推进到大隐静脉和皮肤之间创建的瘘管，来进行血液清除/返回的技术。
在这项研究中，我们评估了 2017 年 5 月至 2022 年 4 月期间在我院创建 VCF 的 40 名患者的 46 条肢体。在所有患者中，由于一般/血管状况，难以构建动静脉瘘或动静脉移植物。根据瘘管创建后透析治疗和瘘管使用的结果来评估这种方法的有用性。
基础评估证实血管壁增厚随时间推移而进展。在临床复查期间，在瘘管创建手术期间或之后，没有发现任何患者出现严重并发症。感染率为每 1000 天瘘管维护 0.30 例。Kaplan-Meier 方法的二次通畅率在 1 年时为 87.0%，在 3 年时为 42.6%。
该方法具有良好的通畅率、低感染率，对于那些难以建立血管通路的患者来说，似乎是一种潜在有用的替代方法。
