Huo Guijun, Xue Jianhui, Zheng Jin, Tang Yao, Zhou Dayong
The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, No. 26 Daoqian Street, Suzhou, Jiangsu, China.
Sci Rep. 2025 Jun 3;15(1):19375. doi: 10.1038/s41598-025-05133-7.
The purpose of this study was to determine predictors of hemodialysis access patency after drug-coated balloon angioplasty (DCBA) in patients with arteriovenous fistula (AVF). The clinical and imaging data of patients with hemodialysis access dysfunction treated with drug-coated balloon (DCB) in our hospital from January 2020 to January 2024 were analyzed retrospectively, the patency of hemodialysis access was followed up. The length of the DCB is 4 cm. Kaplan-Meier analysis was performed for determination of primary patency and secondary patency in this population. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify predictors of primary patency after DCBA. A total of 173 hemodialysis patients treated with DCB were included in the study. The median survival time of primary and secondary patency were 443 and 1035 days, and the primary patency rates at 6, 12, 18, 24, 30 and 36 months were 85.9%, 64.1%, 34.1%, 21.3%, 12.0% and 6.0%, respectively. The secondary patency rates at 6, 12, 18, 24, 30 and 36 months were 98.8%, 93.8%, 89.8%, 81.9%, 76.1% and 48.6%, respectively. Multivariate analysis using Cox proportional hazard regression models showed that lesion length>4 cm(p=0.002), tandem stenosis(p=0.007) and thrombosis (p < 0.001) were independent risk factors for primary patency after DCBA in patients with AVF. However, lesion length (p=0.021), residual stenosis (p=0.022), and thrombosis (p=0.018) were the independent predictors of primary patency in patients with single lesions.Lesion length>4 cm, tandem stenosis and thrombosis were found to be predictors of primary patency after using 4 cm length DCB. However, in patients with single lesions, lesion length, residual stenosis, and thrombosis serve as independent predictors of primary patency.
本研究的目的是确定动静脉内瘘（AVF）患者在药物涂层球囊血管成形术（DCBA）后血液透析通路通畅的预测因素。回顾性分析了2020年1月至2024年1月在我院接受药物涂层球囊（DCB）治疗的血液透析通路功能障碍患者的临床和影像学资料，并对血液透析通路的通畅情况进行随访。DCB的长度为4厘米。采用Kaplan-Meier分析确定该人群的初级通畅率和次级通畅率。进行单因素和多因素Cox比例风险回归分析，以确定DCBA后初级通畅的预测因素。本研究共纳入173例接受DCB治疗的血液透析患者。初级通畅和次级通畅的中位生存时间分别为443天和1035天，6、12、18、24、30和36个月时的初级通畅率分别为85.9%、64.1%、34.1%、21.3%、12.0%和6.0%。6、12、18、24、30和36个月时的次级通畅率分别为98.8%、93.8%、89.8%、81.9%、76.1%和48.6%。使用Cox比例风险回归模型进行的多因素分析表明，病变长度>4厘米（p=0.002）、串联狭窄（p=0.007）和血栓形成（p<0.001）是AVF患者DCBA后初级通畅的独立危险因素。然而，病变长度（p=0.021）、残余狭窄（p=0.022）和血栓形成（p=0.018）是单病变患者初级通畅的独立预测因素。发现病变长度>4厘米、串联狭窄和血栓形成是使用4厘米长DCB后初级通畅的预测因素。然而，在单病变患者中，病变长度、残余狭窄和血栓形成是初级通畅的独立预测因素。
