能否满足KDOQI干预率目标用药物涂层气球用于功能障碍动脉静脉:IN.PACT AV Access随机临床试验的后期分析
Anjana Gopal1, Hiroaki Haruguchi2, Andrew Holden3
1Department of Medicine, Division of Nephrology, University Health Network, Toronto, Ontario, Canada.
概括
与标准血管塑性相比,药物涂层气球 (DCB) 减少了动脉静脉 (AVF) 穿透性的干预和血栓形成. 这两种方法都达到了KDOQI的目标,证明了有效的AVF维护.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 血管外科 血管外科
- 干预性放射学 干预性放射学
背景情况:
- 病结果质量倡议 (KDOQI) 2019年指导方针建议在动脉静脉 (AVF) 穿透性方面每年进行≤3次干预.
- 药物涂层气球 (DCB) 可能比标准的皮肤透光血管造形术 (PTA) 提供更好的结果,用于维护AVF.
研究的目的:
- 评估在临床试验中对AVF通透性的干预是否与KDOQI目标保持一致.
- 为了比较DCB与PTA在降低血栓形成和AVF维护再干预率方面的疗效.
主要方法:
- 对IN.PACT AV Access随机临床试验的后期分析.
- 患有AVF和de novo或re-stenotic病变的成年血液透析患者被随机分配到DCB或PTA.
- 计算干预率和血栓形成率,并与KDOQI 2019年36个月的目标进行比较.
主要成果:
- 无论是DCB和PTA组都实现了KDOQI目标 (≤3次干预/年).
- 在DCB组需要更少的干预穿透 (1.39/AVF年) 与PTA (1.66/AVF年) (P=0.01) 相比.
- 与PTA (0.069) 相比,DCB组的访问电路血栓发生率较低 (0.041),尽管在统计学上并不显著 (P=0.1).
结论:
- 无论是DCB还是PTA都有效地在KDOQI指南中保持AVF通透性.
- 与PTA相比,DCB在36个月内显示了重复干预的显著减少和较低血栓形成率的趋势.
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