Choi Hyun Young, Jung Gyoo-Sik, Kang Hee, Kim Ye Na, Moon Hyung Hwan, Yun Jong Hyouk
Taehan Yongsang Uihakhoe Chi. 2022 May;83(3):658-668. doi: 10.3348/jksr.2021.0086. Epub 2021 Dec 11.
To evaluate the effectiveness of the transradial artery approach (TRA) for treating malfunctioning arteriovenous fistulas (AVFs) in patients on hemodialysis.
A retrospective analysis was conducted in this single-center study of TRA endovascular procedures in 73 patients (43 male and 30 female; mean age of 67.4 years (range, 42-92 years) with malfunctioning AVFs, between January 2008 and April 2019. Patients' baseline and lesion characteristics, technical and clinical success, and complications were evaluated, and functional patency was analyzed using the Kaplan-Meier method.
Radial artery approaches were successful in all patients. Angioplasty performed using the TRA achieved technical and clinical success rates of 98.6%(72/73) and 91.7%(67/73), respectively. The median primary patency time was 18.8 ± 15.9 months. The primary functional patency rates at 3, 6, and 12 months were 82.1%, 68.6%, and 63.9%, respectively. There were no major complications or adverse events, such as hand ischemia, related to the radial artery approach.
In selected cases, the TRA can be used complementary to the transvenous approach to treat malfunctioning AVFs.
评估经桡动脉途径（TRA）治疗血液透析患者动静脉内瘘（AVF）功能障碍的有效性。
本单中心研究对2008年1月至2019年4月期间73例（男43例，女30例；平均年龄67.4岁，范围42 - 92岁）AVF功能障碍患者的TRA血管内介入手术进行回顾性分析。评估患者的基线和病变特征、技术和临床成功率及并发症，并采用Kaplan-Meier法分析功能通畅情况。
所有患者经桡动脉途径均成功。经TRA进行的血管成形术技术成功率和临床成功率分别为98.6%（72/73）和91.7%（67/73）。中位初次通畅时间为18.8±15.9个月。3、6和12个月时的初次功能通畅率分别为82.1%、68.6%和63.9%。未发生与桡动脉途径相关的重大并发症或不良事件，如手部缺血。
在特定病例中，TRA可作为经静脉途径的补充用于治疗功能障碍的AVF。
