Nonmaturing Fistulae: Epidemiology, Possible Interventions, and Outcomes
Nonmaturing Fistulae: Epidemiology, Possible Interventions, and Outcomes
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DOI：
10.1053/j.tvir.2016.11.004
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发表时间：
2017-03-01
影响因子：
1.7
通讯作者：
Irani, Zubin
中科院分区：
文献类型：
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作者：
Sheth, Rahul A.;Freed, Robert;Irani, Zubin
自体动静脉内瘘是延长成功透析通路的最佳方法。然而，透析瘘的一个实质性限制是其原发性失败率高，估计放射头瘘高达70%。瘘管成熟受人口统计学风险因素以及解剖学障碍的影响，后者可以通过无创超声成像和体格检查轻松识别。这些障碍可分为流入问题（自体动脉疾病、动静脉吻合口狭窄和近吻合口狭窄）或流出问题（近端静脉狭窄或侧支静脉）。静脉狭窄是最常见的瘘管成熟障碍。通过采用系统的方法治疗这些障碍，介入医生可以显著提高瘘管可用于透析的可能性。(C)2017爱思唯尔公司All rights reserved.
Autogenous arteriovenous fistulae are the best method for prolonged, successful dialysis access. However, a substantial limitation of dialysis fistulae is their high primary failure rate, estimated to be as high as 70% for radiocephalic fistulae. Fistula maturation is influenced by demographic risk factors as well as anatomical barriers, the latter of which can be readily identified by noninvasive ultrasound imaging and physical examination. These barriers can be categorized as inflow problems (native arterial disease, arteriovenous anastomotic stenosis, and juxta-anastomotic stenosis) or outflow problems (proximal venous stenosis or collateral veins). Venous stenoses represent the most commonly observed barrier to fistula maturation. By treating these barriers with a systematic approach, interventionalists can significantly improve the likelihood of a fistula's usability for dialysis. (C) 2017 Elsevier Inc. All rights reserved.