自主前臂动脉静脉循环血管接入,一个需要考虑的选项
Victoria Gamé1, Gaspar Mestres1, Xavier Yugueros1
1Vascular Access Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain.
The journal of vascular access
|November 8, 2023
概括
自主前臂环为血液透析提供了可行的血管接入选择,显示出良好的成熟率和通透率. 应考虑使用这种技术,以保护上臂血管,以满足未来的访问需求.
科学领域:
- 血管外科 血管外科
- 腎臟病學 (nephrology) 是一種醫學.
- 慢性病管理 慢性病管理
背景情况:
- 自主动脉静脉囊是血液透析的标准.
- 当放射性动脉不适合时,自主前臂环是一种替代方案.
- 关于前臂环有用性的证据是有限的.
研究的目的:
- 报告自生前臂环动脉静脉囊创建的结果.
- 为了评估成熟率,利用率和通透率.
- 评估与这种血管接入相关的并发症.
主要方法:
- 前臂环动脉静脉囊的前性队列研究 (2010-2022年).
- 包括患有4-5期慢性病的患者.
- 收集有关人口统计,手术,静脉类型,随访 (24个月),成熟,利用,通透性和并发症的数据.
主要成果:
- 创建了22个自主前臂环 (14个头骨静脉,8个基底静脉).
- 6周成熟率:61.9%; 6个月初级通透率:75.4%; 2年二次通透率:56.9%.
- 在5名患者中发生了访问诱导的远端缺血症;没有报告任何感染.
结论:
- 自主前臂环显示可接受的成熟度和穿透率.
- 这种方法是血液透析血管接入的有价值的替代方案.
- 考虑前臂环节,以保护近亲手臂血管系统,以便在未来进行干预.
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