Using ultrasound in preoperative mapping and surveillance of arteriovenous grafts for haemodialysis improves patency rates: Single-centre experience.

IF 1.6 3区医学 Q3 PERIPHERAL VASCULAR DISEASE Journal of Vascular Access Pub Date : 2024-12-26 DOI:10.1177/11297298241308377

Julia Jarosciakova, Petr Utikal, Jan Malik, Jana Janeckova

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Abstract

Background: This study aimed to evaluate patency outcomes of arteriovenous grafts (AVGs) before and after using Duplex doppler ultrasonography (DUS) in preoperative mapping and surveillance of AVG.

Methods: In this single-centre, retrospective cohort study 212 patients receiving AVGs from January 2009 to December 2022 were included. In group 1, the creation of AVG as well as screening was based on physical examination alone. In contrast, DUS was used in the preoperative mapping and surveillance of AVG in group 2. The patients also received sulodexide as supplemental medication. Outcomes included primary and secondary patency. The Mann-Whitney U-test was used to compare the differences between groups in number of thrombectomies and preemptive percutaneous transluminal angioplasties (PTAs).

Results: Group 1 included 90 AVGs. The mean follow-up time was 333 days (range: 1-1230 days, standard deviation: 318 days). The primary and secondary graft patency rates were 13.3%, 62.2% at 6 months; 2.2%, 52.1% at 12 months; 0%, 44.3% at 24 months and 0%, 44.3% at 36 months respectively. During the 7-year surveillance of AVG, significantly more thrombectomies were performed than preemptive PTA (p < 0.0001). Group 2 included 122 AVGs. The mean follow-up time was 584 days (range: 1-2040 days, standard deviation: 463 days). The primary and secondary graft patency rates were 54.9%, 95.9% at 6 months; 29.5%, 77.8% at 12 months; and 9.8%, 56.5% at 24 months; 2.5%, 47.1% at 36 months respectively. The primary and secondary graft patency was significantly longer (p < 0.0001, p = 0.002). During the 7-year surveillance of AVG there were significantly more preemptive PTAs performed (p = 0.0004).

Conclusions: The primary and secondary patency of AVG were significantly improved after using DUS in preoperative mapping and surveillance. DUS surveillance led to a decrease in AVG occlusion. A potential positive effect of sulodexide on patency rate of AVG needs more research.

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超声在血液透析动静脉移植物术前制图和监测中提高了通畅率：单中心经验。

背景：本研究旨在评估双多普勒超声（DUS）在动静脉移植物（avg）术前定位和监测前后的通畅情况。方法：在这项单中心回顾性队列研究中，纳入了2009年1月至2022年12月接受动静脉移植物治疗的212例患者。在第1组中，AVG的创建和筛选仅基于身体检查。第二组采用DUS进行AVG的术前测图和监测。患者还接受了舒洛地特作为补充药物。结果包括原发性和继发性通畅。采用Mann-Whitney u检验比较两组间血栓切除术和先发制人的经皮腔内血管成形术（PTAs）数量的差异。结果：第一组共90例avg。平均随访时间333天（范围1 ~ 1230天，标准差318天）。一期和二期移植通畅率分别为13.3%和62.2%；2.2%， 12个月时为52.1%；24个月为0%，44.3%，36个月为0%，44.3%。在AVG的7年监测期间，血栓切除术的实施明显多于先发制人的PTA （p p p = 0.002）。在7年的AVG监测期间，进行了更多的先发制人的pta （p = 0.0004）。结论：应用DUS进行术前测图和监测后，AVG的原发和继发通畅程度均有明显改善。DUS监测导致AVG闭塞的减少。舒洛地特对AVG通畅率的潜在积极作用有待进一步研究。

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

Journal of Vascular Access 医学-外周血管病

CiteScore

3.40

自引率

31.60%

发文量

181

审稿时长

6-12 weeks

期刊介绍： The Journal of Vascular Access (JVA) is issued six times per year; it considers the publication of original manuscripts dealing with clinical and laboratory investigations in the fast growing field of vascular access. In addition reviews, case reports and clinical trials are welcome, as well as papers dedicated to more practical aspects covering new devices and techniques. All contributions, coming from all over the world, undergo the peer-review process. The Journal of Vascular Access is divided into independent sections, each led by Editors of the highest scientific level: • Dialysis • Oncology • Interventional radiology • Nutrition • Nursing • Intensive care Correspondence related to published papers is also welcome.