需要干预的与血管接入有关的远端缺血症:频率,危险因素和后果
Michael Allon1, Gary R Cutter2, Carlton J Young3
1Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama.
Clinical journal of the American Society of Nephrology : CJASN
|September 14, 2023
概括
动脉静脉 (AV) 或移植后的远端缺血是罕见的,影响1.9%的患者. 女性性别和血管疾病增加风险,但随后的接入放置往往是成功的.
科学领域:
- 血管外科 血管外科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 透析服务 透析服务 透析服务
背景情况:
- 远端缺血是动脉静脉 (AV) 或移植植入后的一个罕见但严重的并发症.
- 有限的数据存在于频率,风险因素和与接入相关的远端缺血的结果.
研究的目的:
- 为了确定需要干预的与接入相关的远端缺血的频率.
- 确定与其发展相关的临床风险因素.
- 评估随后的血管接入安置的可行性和结果.
主要方法:
- 从2011年到2020年,对一个潜在的血管接入数据库进行了回顾性分析.
- 包括1498名接受AV接入安置的患者.
- 鉴定和分析患有需要手术干预的远端缺血症的患者.
主要成果:
- 在1.9%的患者中,严重的与接入相关的远端缺血发生.
- 独立的风险因素包括女性性别 (OR 3.64),周围血管疾病 (OR 6.28) 和冠状动脉疾病 (OR 2.37).
- 随后在13名患者中进行了AV移植,结果只有一例 (8%) 的复发性缺血需要干预.
结论:
- 与接入相关的需要干预的远端缺血不常见.
- 女性患者和患有外周或冠状动脉疾病的患者面临更高的风险.
- 随后的血管接入可以安全地放置,复发风险低.
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