连接静脉的强迫成熟的小口径动脉静脉
Miju Bae1, Chung Won Lee1, Sung Woon Chung1
1Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, Republic of Korea; Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
Annals of vascular surgery
|April 7, 2024
概括
重合辅助静脉在动脉静脉 (AVF) 成熟时有效,当主静脉不清楚时. 这种手术技术确保成功创建AVF,即使牺牲静脉是困难的.
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:
- 自生动脉静脉囊 (AVF) 的产生对于血液透析的准入至关重要.
- 辅助静脉可以使AVF成熟复杂化,导致潜在的失败.
- 强制成熟技术用于优化AVF的发展.
研究的目的:
- 评估重新连接主流和辅助静脉的有效性,以强制成熟AVF.
- 为了确定静脉重聚是否在具有挑战性的情况下改善AVF成熟的成功.
- 为了评估AVF成熟的结果,在患有辅助静脉的患者中使用静脉重新连接.
主要方法:
- 一项回顾性研究包括23名通过静脉重新连接进行强制成熟的患者 (2018年1月-2022年9月).
- 静脉重新连接是当分辨主要分支是困难的考虑,特别是几乎相同大小的静脉超过6毫米的总直径.
- 在47.8%的患者中,手术重新连接涉及动脉和静脉管部位.
主要成果:
- 复合后,静脉的平均尺寸从0.35厘米显著增加到0.69厘米 (P < 0.01),而流量没有显著变化.
- 实现了100%的成熟和管成功率.
- 一年初级通透率为82.0%,其中34.8%需要皮肤透光血管整形,11.8%在重新连接的部分经历了狭窄.
结论:
- 静脉复合是AVF成熟的有效策略,当辅助静脉使主要静脉的识别复杂化时.
- 这种技术是一个可行的选择,当牺牲一个静脉可能会阻碍成功的AVF成熟.
- 重组手术为具有挑战性的AVF病例提供了解决方案,改善了成熟率和通透率.
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