Correlation between preoperative cephalic vein pathological types and autogenous arteriovenous fistula (AVF) maturation in patients with stage 5 chronic kidney disease.

IF 2.1 3区医学 Q2 SURGERY Langenbeck's Archives of Surgery Pub Date : 2024-10-04 DOI:10.1007/s00423-024-03487-6

Mingjiao Pan, Cuijuan Wang, Yafei Bai, Mingzhi Xu, Yonghui Qi, Ruman Chen

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Abstract

Purpose: To explore the correlation between preoperative cephalic vein pathological types and the maturation of autogenous arteriovenous fistula (AVF) in patients with chronic kidney disease (CKD), providing new ideas and methods for clinical prediction of fistula maturation.

Methods: A retrospective analysis was performed in 80 patients who underwent AVF creation surgery from June 2021 to June 2023 at our hospital. Patients were followed up for 6 months. Patients were classified into the mature group (n = 57) and the power loss group (n = 23) based on the AVF maturation status. Preoperative excised venous tissues were examined using Masson's trichrome staining to compare the intimal area (Ia), medial area (Ma), lumen diameter (Ld), average intimal thickness (Avg It), and average medial thickness (Avg Mt), along with the calculations and comparisons of Ia/Ma, Avg It/Avg Mt ratios. Factors influencing AVF power loss were identified using the multifactorial logistic regression analysis.

Results: Ia, Ia/Ma, and Ld were lower in the power loss group compared to the mature group (P < 0.01). No significant difference was found in Avg Mt and Avg It/Avg Mt levels between the two groups (P > 0.05). The level of Avg It was higher in the power loss group (P < 0.05). Avg It was a risk factor (P < 0.001), while Ld was a protective factor for AVF power loss (P < 0.05).

Conclusion: The levels of Avg It and Ld in preoperative cephalic vein tissue before AVF formation were correlated with AVF power loss. Early monitoring may improve therapeutic outcomes and prognosis of patients with stage 5 CKD.

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慢性肾脏病 5 期患者术前头静脉病理类型与自体动静脉瘘（AVF）成熟度的相关性。

目的：探讨慢性肾脏病（CKD）患者术前头静脉病理类型与自体动静脉瘘（AVF）成熟度的相关性，为临床预测瘘管成熟度提供新的思路和方法：方法：对2021年6月至2023年6月期间在我院接受动静脉瘘创建手术的80名患者进行回顾性分析。对患者进行了 6 个月的随访。根据动静脉瓣膜成熟情况，将患者分为成熟组（57 人）和动力丧失组（23 人）。术前切除的静脉组织采用马森三色染色法进行检查，比较内膜面积（Ia）、内侧面积（Ma）、管腔直径（Ld）、平均内膜厚度（Avg It）和平均内侧厚度（Avg Mt），并计算和比较 Ia/Ma、Avg It/Avg Mt 比值。使用多因素逻辑回归分析确定了影响 AVF 功率损失的因素：结果：与成熟组相比，功率损失组的 Ia、Ia/Ma 和 Ld 更低（P 0.05）。功率损耗组的 Avg It 水平更高（P 0.05）：在 AVF 形成之前，术前头静脉组织中的 Avg It 和 Ld 水平与 AVF 失功相关。早期监测可改善 CKD 5 期患者的治疗效果和预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.