Mi L H, Bao X D, Shi Y X, Yu M, Liu S J, Wu C, Fu X Y
Department of Vascular Surgery, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
Zhonghua Yi Xue Za Zhi. 2024 Aug 20;104(32):3032-3036. doi: 10.3760/cma.j.cn112137-20240331-00733.
To evaluate the long-term outcomes of lower extremity arteriovenous graft (AVG) in hemodialysis patients. Hemodialysis patients with lower extremity AVG from August 2015 to July 2023 in the Department of Vascular Surgery, Longhua Hospital, Shanghai University of Traditional Chinese Medicine were enrolled. Therapeutic effects and complications of AVG were retrospectively analyzed. A total of 83 cases aged (58.9±13.3) years were enrolled, including 25 males and 58 females. The success rate of the operation was 100% (83/83), and no perioperative complications occurred. The follow-up time [ (, )] was 38.4 (22.6, 55.3) months, with a follow-up rate of 92.8% (77/83). There were 9 cases (11.7%) of puncture site infection, 5 cases (6.5%) of pseudoaneurysm, 2 cases (2.6%) of seroma, 3 cases (3.9%) of lower limb ischemia, 48 cases (62.3%) of stenosis and 24 cases (31.2%) of thrombosis during the follow-up period. The 6-month, 1-year, 2-year, 3-year and 5-year primary patency rates after surgery were 78.9%, 61.2%, 39.0%, 27.0% and 16.3%, respectively, assisted primary patency rates were 93.5%, 82.5%, 74.9%, 68.0% and 53.0%, respectively, and secondary patency rates were 96.1%, 94.7%, 93.1%, 91.3% and 75.3%, respectively. For patients whose vascular resources of upper limbs are exhausted, lower extremity AVG is a safe and effective hemodialysis vascular access.
评估血液透析患者下肢动静脉内瘘(AVG)的长期疗效。纳入2015年8月至2023年7月上海中医药大学附属龙华医院血管外科行下肢AVG的血液透析患者。回顾性分析AVG的治疗效果及并发症。共纳入83例患者,年龄(58.9±13.3)岁,其中男性25例,女性58例。手术成功率为100%(83/83),无围手术期并发症发生。随访时间[(,)]为38.4(22.6,55.3)个月,随访率为92.8%(77/83)。随访期间发生穿刺部位感染9例(11.7%)、假性动脉瘤5例(6.5%)、血清肿2例(2.6%)、下肢缺血3例(3.9%)、狭窄48例(62.3%)、血栓形成24例(31.2%)。术后6个月、1年、2年、3年和5年的一期通畅率分别为78.9%、61.2%、39.0%、27.0%和16.3%,辅助一期通畅率分别为93.5%、82.5%、74.9%、68.0%和53.0%,二期通畅率分别为96.1%、94.7%、93.1%、91.3%和75.3%。对于上肢血管资源耗尽的患者,下肢AVG是一种安全有效的血液透析血管通路。