Sites of stenosis in AV fistulae for haemodialysis access
Sites of stenosis in AV fistulae for haemodialysis access
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DOI：
10.1093/ndt/14.1.118
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发表时间：
1999-01-01
影响因子：
6.1
通讯作者：
Bakran, A
中科院分区：
文献类型：
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作者：
Sivanesan, S;How, TV;Bakran, A
背景桡动脉头动静脉瘘的晚期失败大部分与内膜增生的进展有关。这一过程的病因尚不清楚，但瘘的配置和由此产生的血流动力学已牵连。本临床研究旨在确定瘘患者的狭窄部位，并将结果与各种临床和几何参数联系起来。术中测量25例连续瘘管的吻合长度和角度。术后定期使用双功超声和彩色血流超声进行评估。在3个月时，研究的所有25个瘘管均存在狭窄。狭窄可分为三个特定部位：吻合处（1型）、头静脉弯曲区域内壁（2型）和静脉伸直处弯曲节段近端（3型）。1型和2型狭窄大多数不进展，3型狭窄一般进展。这些发现强调需要一个有效的监测计划动静脉瘘。
Background. A large proportion of late failures of radiocephalic arteriovenous fistulae are related to the progression of intimal hyperplasia. The aetiology of this process is still unknown but the fistula configuration and resultant haemodynamics have been implicated. This clinical study was devised to identify sites of stenosis in patients with fistulae and relate the findings to various clinical and geometrical parameters.Method. Measurement of anastomotic length and angle was made intraoperatively in 25 consecutive fistulae. Post-operative assessment was carried out at regular intervals using duplex and colour-flow ultrasonography.Results. Stenoses were present in all 25 of the fistulae studied at 3 months. The stenoses could be classified to three specific sites: at the anastomosis (Type 1), on the inner wall of the curved region of the cephalic vein (Type 2) and just proximal to this curved segment where the vein straightens out (Type 3). Most of Type 1 and Type 2 stenoses were not progressive while Type 3 stenoses were generally progressive.Conclusion. These findings emphasize the need for an effective surveillance programme of AV fistulae.