Winsett O E, Wolma F J
South Med J. 1985 May;78(5):513-7. doi: 10.1097/00007611-198505000-00004.
This study of 533 vascular access sites for long-term hemodialysis in patients with end-stage renal disease, accumulating more than 12,000 patient months, indicated that primary arteriovenous fistula (AVF) is the procedure of choice. The group receiving primary AVF had the greatest duration of patency: 84% at three years compared to 70% for the group receiving polytetrafluoroethylene (PTFE) grafts and less than 50% for those receiving bovine carotid artery heterografts (BCAH). Furthermore, the primary AVF group had fewer complications (25 complications in 273 fistulas) than either the BCAH group (61 in 58 grafts) or the PTFE group (171 in 202 grafts). No complication resulted in death in the primary AVF group, but seven deaths resulted from complications of the access in the graft groups, further solidifying the position of the primary AVF as the procedure of choice for chronic hemodialysis access.
这项针对533个终末期肾病患者长期血液透析血管通路部位的研究，累计患者月数超过12000个，表明自体动静脉内瘘（AVF）是首选术式。接受自体AVF的组通畅时间最长：三年时为84%，相比之下，接受聚四氟乙烯（PTFE）移植物的组为70%，接受牛颈动脉异种移植物（BCAH）的组则低于50%。此外，自体AVF组的并发症（273个内瘘中有25例并发症）比BCAH组（58个移植物中有61例）或PTFE组（202个移植物中有171例）都少。自体AVF组没有并发症导致死亡，但移植物组有7例死亡是由血管通路并发症引起的，这进一步巩固了自体AVF作为慢性血液透析血管通路首选术式的地位。
