Low-pressure environment and remodelling of the forearm vein in Brescia-Cimino haemodialysis access
Low-pressure environment and remodelling of the forearm vein in Brescia-Cimino haemodialysis access
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DOI：
10.1093/ndt/17.6.1057
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发表时间：
2002-06-01
影响因子：
6.1
通讯作者：
Hayoz, D
中科院分区：
文献类型：
--
作者：
Corpataux, JM;Haesler, E;Hayoz, D
背景资料。该研究的目的是确定哪些血流动力学参数以及在多大程度上影响Brescia-Cimino血液透析通路静脉肢体的重塑。用回声跟踪技术测量血液透析通路的桡动脉和静脉的大小。对6例行动静脉内瘘(AVF)形成的ESRD患者，分别于术后、术后1个月和术后3个月测量血管内径、管壁厚度、血压和血流量。以对侧前臂血管的原始位置作为基线值进行比较。在研究期间，肘前静脉近端的直径逐渐增大，但无显著差异(第1、4和12周分别为4430、5041和6620微米)，而内膜-中层厚度保持不变。静脉扩张与平均切应力的降低有关，平均切应力在术后达到最大值，并在3个月逐渐恢复到正常静脉值(24.5vs10.4dyne/cm(2)P<；0.043)。室壁横截面积增加(1周4.42vs6.32mm2 vs12周，P
Background. The aim of the study was to determine which, and to what extent, haemodynamic parameters contribute to the remodelling of the venous limb of the Brescia-Cimino haemodialysis access.Methods. The dimensions of the radial artery and the venous limb of the haemodialysis access were measured by an echo-tracking technique. In six ESRD patients undergoing primary arteriovenous fistula (AVF) formation, vessel diameter, wall thickness, blood pressure and blood flow were measured after the operation, and at I and 3 months follow-up. The contralateral forearm vessels in their native position served as baseline values for comparison.Results. The diameter of the proximal antecubital vein progressively increased over the study period without reaching significant differences (4430, 5041 and 6620 mum at weeks 1, 4 and 12 respectively), whereas the intima-media thickness remained unchanged. The venous dilatation was associated with a reduction of the mean shear stress that culminated after the operation and progressively returned to normal venous values at 3 months (24.5 vs 10.4 dyne/cm(2) P < 0.043). Thus the venous limb of the AVF undergoes eccentric hypertrophy as demonstrated by the increase in wall cross-sectional area (4.42 vs 6.32 mm 2 at week 1 vs week 12, P