Interwoven nitinol stent-assisted arteriovenous fistula maturation: 2 year-outcomes of a single center experience.

IF 1 4区医学 Q4 PERIPHERAL VASCULAR DISEASE Vascular Pub Date : 2024-11-15 DOI:10.1177/17085381241301536

Veera Suwanruangsri, Surakiat Bokerd, Virapat Chanchitsopon

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Abstract

Objectives: The aim of this study was to report 2-year outcomes of interwoven nitinol (Supera^TM) stent-assisted arteriovenous fistula (AVF) maturation in patients who presented with non-matured AVF.

Methods: We reviewed the clinical data of 20 patients who presented with non-matured AVF (19 patients with brachiocephalic AVF and 1 patient with radiocephalic AVF) and underwent balloon angioplasty followed by Supera^TM stenting in the cephalic vein for long-term hemodialysis between January 2017 and January 2022. The outcomes were evaluated in these patients in terms of technical success, post-intervention complications, reintervention, and cumulative patency (6 months, 1 year, and 2 years).

Results: The study included 20 patients who presented with non-matured AVF. The mean age of the patients was 65 years (range, 40-85). The Supera^TM stents of size 6.5 mm were used in 15 patients (75%), and those of 7.5 mm and 5.5 mm were used in 4 (20%) and 1 (5%) patient, respectively. The average stent length was 99.5 mm (range, 80-120). Technical success was achieved in all patients. Early use within 1 week by needling at the Supera^TM stent segment (cannulation zone) was successful in all patients without any complications. The mean follow-up time was 24.5 months. During the follow-up period, reinterventions to maintain the function of AVF were performed in 8 patients (40%) (7 patients with juxta-anastomotic stenosis, 1 patient with in-stent restenosis). The reintervention rate was 0.39 procedures per patient per year. The primary patency at 6 months, 1 year, and 2 years were 85.5%, 62.6%, and 54.2%, respectively. The assisted primary patency at 6 months, 1 year, and 2 years were 95%, 84.5%, and 78.8%, respectively.

Conclusions: The use of the Supera^TM stent to improve the AVF maturation rate was associated with acceptable outcomes at 2 years. Its benefit over other strategies was the early use of the access for hemodialysis.

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镍钛诺交织支架辅助动静脉瘘成熟：一个中心两年的经验成果。

研究目的本研究旨在报告交织镍钛醇（SuperaTM）支架辅助动静脉瘘（AVF）成熟的两年结果：我们回顾了 2017 年 1 月至 2022 年 1 月间 20 例非成熟性动静脉瘘患者（19 例肱骨动静脉瘘患者和 1 例射血动静脉瘘患者）的临床数据，这些患者接受了球囊血管成形术，然后在头静脉内植入 SuperaTM 支架，用于长期血液透析。研究从技术成功率、介入后并发症、再次介入和累积通畅率（6 个月、1 年和 2 年）等方面对这些患者的结果进行了评估：研究共纳入 20 名非成熟性动静脉瘘患者。患者的平均年龄为 65 岁（40-85 岁不等）。15 名患者（75%）使用了 6.5 毫米的 SuperaTM 支架，4 名患者（20%）和 1 名患者（5%）分别使用了 7.5 毫米和 5.5 毫米的支架。支架平均长度为 99.5 毫米（范围为 80-120）。所有患者都取得了技术成功。所有患者均在 1 周内通过针刺 SuperaTM 支架节段（插管区）的方式提前使用了支架，未出现任何并发症。平均随访时间为 24.5 个月。在随访期间，有 8 名患者（40%）为维持动静脉瘘的功能进行了再介入治疗（7 名患者为并行吻合口狭窄，1 名患者为支架内再狭窄）。每名患者每年的再介入率为 0.39 次。6个月、1年和2年的初次通畅率分别为85.5%、62.6%和54.2%。6个月、1年和2年的辅助初次通畅率分别为95%、84.5%和78.8%：结论：使用 SuperaTM 支架提高动静脉瘘成熟率与 2 年后可接受的结果有关。与其他策略相比，该方法的优势在于能尽早使用血液透析通路。

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

Vascular 医学-外周血管病

CiteScore

2.30

自引率

9.10%

发文量

196

审稿时长

6-12 weeks

期刊介绍： Vascular provides readers with new and unusual up-to-date articles and case reports focusing on vascular and endovascular topics. It is a highly international forum for the discussion and debate of all aspects of this distinct surgical specialty. It also features opinion pieces, literature reviews and controversial issues presented from various points of view.