Arteriovenous fistula maturation and the influence of fluid dynamics
Arteriovenous fistula maturation and the influence of fluid dynamics
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DOI：
10.1177/0954411920926077
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发表时间：
2020-06-27
期刊：
影响因子：
1.8
通讯作者：
Barber, Tracie
中科院分区：
文献类型：
--
作者：
Colley, Eamonn;Simmons, Anne;Barber, Tracie
动静脉内瘘建立是血液透析治疗的首选血管通路，但在成熟期失败率较高。这一时期通常在手术创建后持续 6 至 8 周，在此期间静脉和动脉经历广泛的血管重塑。在这篇综述中，我们概述了动静脉内瘘成熟和动静脉内瘘失败的拟议机制。尽管已经提出了许多基于壁剪切应力指标的理论，但临床、动物和计算研究尚未表明任何指标与疾病发展之间存在明确的联系。最近允许基于患者的纵向研究的工作可能是理解动静脉瘘成熟过程的关键。
Arteriovenous fistula creation is the preferred vascular access for haemodialysis therapy, but has a large failure rate in the maturation period. This period generally lasts 6 to 8 weeks after surgical creation, in which the vein and artery undergo extensive vascular remodelling. In this review, we outline proposed mechanisms for both arteriovenous fistula maturation and arteriovenous fistula failure. Clinical, animal and computational studies have not yet shown a definitive link between any metric and disease development, although a number of theories based on wall shear stress metrics have been suggested. Recent work allowing patient-based longitudinal studies may hold the key to understanding arteriovenous fistula maturation processes.