关于最小血管直径和动脉静脉结结局的指导建议
Letty V van Vliet1,2, Niek Zonnebeld1,3, Jan H Tordoir2
1Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
The journal of vascular access
|June 19, 2023
概括
对动脉静脉形成的临床指南的证据有限. 血管直径建议并不总是与更好的结果相关,除了前臂囊,较小的血管功能不佳.
科学领域:
- 血管外科 血管外科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 透析的访问 透析的访问
背景情况:
- 临床指导方针建议针对动脉静脉 (AVF) 产生特定的最小血管直径.
- 支持这些直径建议的证据有限.
- 本研究基于遵守ESVS临床实践指南来评估AVF结果.
研究的目的:
- 为了比较创建在ESVS指导方针中和外的AVF的血管访问结果,ESVS指导方针对最小血管直径的建议.
- 评估术前血管大小对管功能和干预率的影响.
主要方法:
- 一项多中心研究,包括211名接受血液透析的患者,这些患者经历了囊形成 (放射性脑,脑或脑).
- 术前双重超声波测量动脉和静脉直径的标准化.
- 结果包括6周的超声波发现,血管接入功能和1年后的干预率.
主要成果:
- 55%的AVF是根据ESVS指南创建的 (前臂的动脉/静脉>2mm,上臂>3mm).
- 遵循指导方针并没有显著改善整体管功能或降低干预率.
- 在指导方针之外创建的前臂AVF (<2mm血管) 显示功能性及时访问明显较差 (52%).
结论:
- 上臂AVF <3mm的功能与较大的血管相似,但前臂AVF <2mm的结果不佳.
- 目前关于最小容器直径的指导方针建议可能不适用于所有人.
- 支持基于患者特定血管特征的个人化方法来创建AVF.
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