Hashimoto Koji, Harada Makoto, Yamada Yosuke, Kanno Taro, Kanno Yutaka, Kamijo Yuji
Department of Nephrology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
Kanno Dialysis and Vascular Access Clinic, 2-17-5 Tsukama, Matsumoto 390-0821, Japan.
J Clin Med. 2024 Jan 23;13(3):641. doi: 10.3390/jcm13030641.
Vascular access (VA) flow suppression surgery augments VA flow resistance and can increase other circulation flows hindered by high-flow VA. However, whether VA flow suppression surgery affects cervical circulation has rarely been reported. We aimed to determine the effect of VA flow suppression surgery on the cervical circulation in patients with high-flow VA. This single-center, retrospective, observational study included 85 hemodialysis patients who underwent VA flow suppression surgery at the Kanno Dialysis and Access Clinic between 2009 and 2018. Blood flow in the VA, bilateral vertebral arteries, and common carotid artery was measured before and after VA flow suppression surgery. The VA flow decreased from 1548 mL/min to 693 mL/min postoperatively. The flow of the vertebral artery on the VA side increased from 55 mL/min to 81 mL/min. The flow in the bilateral common carotid arteries also increased. Patients whose symptoms improved postoperatively showed better improvement in the vertebral artery on the VA side. VA flow suppression surgery in patients with high-flow VA increases the flow of the vertebral artery on the VA side and of the bilateral common carotid arteries. High-flow VA can hinder the vertebral and common carotid circulation.
血管通路（VA）血流抑制手术可增加VA血流阻力，并能增加因高流量VA而受阻的其他循环血流。然而，VA血流抑制手术是否影响颈循环鲜有报道。我们旨在确定VA血流抑制手术对高流量VA患者颈循环的影响。这项单中心、回顾性、观察性研究纳入了2009年至2018年间在神野透析与血管通路诊所接受VA血流抑制手术的85例血液透析患者。在VA血流抑制手术前后测量VA、双侧椎动脉和颈总动脉的血流。术后VA血流从1548毫升/分钟降至693毫升/分钟。VA侧椎动脉血流从55毫升/分钟增加到81毫升/分钟。双侧颈总动脉的血流也增加。术后症状改善的患者，其VA侧椎动脉的改善情况更好。高流量VA患者的VA血流抑制手术可增加VA侧椎动脉以及双侧颈总动脉的血流。高流量VA会阻碍椎动和颈总动脉循环。
