Yo Seb Lee, Song Am Lee, Jae Joon Hwang, Jun Seok Kim, Hyun Keun Chee
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引用次数: 0
Abstract
Background: The superficial veins are commonly used in conventional autogenous arteriovenous fistulas and the placement of prosthetic grafts. When they are unsuitable, however, the use of the deep veins (venae comitantes) is generally considered to be a reasonable alternative. This study conducted a comparative analysis of clinical outcomes for arteriovenous grafts between 2 groups based on the type of venous outflow: superficial veins or venae comitantes.
Methods: In total, 151 patients who underwent arteriovenous grafts from November 2005 to March 2022 were retrospectively analyzed. The patients were divided into 2 groups: group A (superficial veins, n=89) and group B (venae comitantes, n=62). The primary, secondary patency, and complication rates were analyzed in each group. A propensity score-matched analysis was performed.
Results: In total, 55 well-balanced pairs were matched. Kaplan-Meier analysis revealed no significant differences in the primary patency rate between the 2 groups at 1-year, 3-year and 5-year intervals (group A, 54.7%, 35.9%, 25.4% vs. group B, 47.9%, 16.8%, 12.6%; p=0.14), but there was a difference in the secondary patency rate (group A, 98.2%, 95.3%, 86.5% vs. group B, 87.3%, 76.8%, 67.6%; p=0.0095). The rates of complications, simple percutaneous transluminal angioplasty, and stent insertion were comparable between the groups.
Conclusion: Although this study demonstrated not particularly favorable secondary patency rates in the venae comitantes group, the venae comitantes may still be a viable option for patients with unsuitable superficial veins because there were no significant differences in the primary patency and complication rates between the 2 groups.
背景:浅静脉常用于传统的自体动静脉瘘和人工移植物的植入。然而,当浅表静脉不适用时,使用深静脉(venae comitantes)通常被认为是一种合理的替代方案。本研究根据静脉流出类型(浅静脉或合并静脉)对两组动静脉移植物的临床疗效进行了比较分析:方法:对2005年11月至2022年3月期间接受动静脉移植手术的151例患者进行回顾性分析。患者分为两组:A组(浅静脉,89人)和B组(合并静脉,62人)。分析了各组的初次、二次通畅率和并发症发生率。进行了倾向得分匹配分析:结果:共有 55 对平衡良好的患者进行了匹配。Kaplan-Meier分析显示,两组在1年、3年和5年的初次通畅率无显著差异(A组,54.7%、35.9%、25.4% vs. B组,47.9%、16.8%、12.6%;P=0.14),但二次通畅率存在差异(A组,98.2%、95.3%、86.5% vs. B组,87.3%、76.8%、67.6%;P=0.0095)。两组的并发症发生率、单纯经皮腔内血管成形术和支架植入率相当:结论:尽管本研究显示合并静脉组的二次通畅率并不特别理想,但对于不适合浅静脉的患者来说,合并静脉仍不失为一种可行的选择,因为两组患者的一次通畅率和并发症发生率没有明显差异。