用于肱动脉-腋动脉动静脉内瘘的移位贵要静脉与聚四氟乙烯的比较
Transposed basilic vein versus polytetrafluorethylene for brachial-axillary arteriovenous fistulas.
作者信息
Matsuura J H, Rosenthal D, Clark M, Shuler F W, Kirby L, Shotwell M, Purvis J, Pallos L L
机构信息
Department of Surgery, Georgia Baptist Medical Center, Medical College of Georgia, Atlanta, USA.
出版信息
Am J Surg. 1998 Aug;176(2):219-21. doi: 10.1016/s0002-9610(98)00122-6.
BACKGROUND
Both transposed basilic vein (BV) and polytetrafluorethylene (PTFE) upper arm arteriovenous fistulas (AVF) are common angioaccess operations. To evaluate the patency and complication rates after AVF, a concurrent series of patients was reviewed.
METHODS
Ninety-eight patients underwent brachial artery to axillary vein AVF: 30 BV and 68 PTFE. The PTFE grafts were performed in the standard fashion, whereas the basilic veins were translocated subcutaneously to the brachial artery.
RESULTS
Risk factors were similar between the two groups. Basilic vein AVF had better patency at 24 months (70% BV versus 46% PTFE, P = 0.023). The dialysis access complications were higher in the BV group (20%) versus PTFE (5%), but the PTFE group had a higher infection rate (10%) than BV (0%).
CONCLUSIONS
The primary and secondary patency rates were superior in the BV AVFs. The BV AVF preserves the venous outflow tract after AVF thrombosis for a future PTFE AVF operation.
背景
转位贵要静脉（BV）和聚四氟乙烯（PTFE）上臂动静脉内瘘（AVF）都是常见的血管通路手术。为评估AVF术后的通畅率和并发症发生率，对一系列同期患者进行了回顾性研究。
方法
98例患者接受了肱动脉至腋静脉的AVF手术：30例采用BV，68例采用PTFE。PTFE移植物采用标准方式进行，而贵要静脉则皮下移位至肱动脉。
结果
两组的危险因素相似。贵要静脉AVF在24个月时的通畅率更高（BV为70%，PTFE为46%，P = 0.023）。BV组的透析通路并发症发生率（20%）高于PTFE组（5%），但PTFE组的感染率（10%）高于BV组（0%）。
结论
BV AVF的一期和二期通畅率更高。BV AVF在AVF血栓形成后保留了静脉流出道，可为未来的PTFE AVF手术做准备。
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