PDF(Pubmed)
Abstract：
Objectives: In this study, we aim to assess the efficacy of revision using distal inflow (RUDI) in patients with symptomatic dialysis access-associated steal syndrome (DASS). Materials and Methods: All consecutive patients who were diagnosed with grade 3 or 4 DASS and have undergone RUDI in 4 years were included in this study. Results: In total, 35 patients were included in this study; participants had a mean age of 47.5±7.52 years and 54% (n=19) were males. As per our findings, significant improvement was noted in terms of paresthesia (81.2%, p-value: 0.012), coolness (79.4%, p-value: 0.006), pain (78.1%, p-value: 0.006), discoloration (76.4%, p-value: 0.044), paresis (71.4%, p-value: 0.016), and ulcer healing (50%, p-value: 0.044). Gangrene did not further progress in all patients (n=35). Reduction in fistula flow rate after RUDI was 57.5% (682±121 ml/min, p-value: 0.001). Digital systolic pressure was noted to improve by 71.4% (60±9.2 mmHg, p-value: 0.002) after RUDI. Peak systolic velocity increased in both ulnar (66.1±8.2 cm/s, p-value: 0.04) and radial (64.2±7.6 cm/s, p-value: 0.024) arteries of the wrist. Cumulative patency of RUDI graft was 100%, 91.4%, and 85.7% at 3, 6, and 12 months, respectively. Conclusion: RUDI has resulted in significant improvements in terms of DASS symptoms. Using a native vein as conduit, RUDI should be considered a procedure of choice for patients with high-flow DASS.
摘要：
目的:在本研究中,我们旨在评估有症状的透析通路相关盗血综合征(DASS)患者使用远端入流(RUDI)进行翻修的疗效.材料和方法：本研究包括所有被诊断为3级或4级DASS并在4年内接受RUDI的连续患者。结果：总的来说，这项研究包括35名患者；参与者的平均年龄为47.5±7.52岁，54％（n=19）为男性。根据我们的发现,在感觉异常方面有显著改善(81.2%，p值:0.012),凉爽度(79.4%，p值:0.006),疼痛（78.1%，p值:0.006),变色(76.4%，p值:0.044),轻瘫(71.4%，p值:0.016),和溃疡愈合（50%，p值：0.044）。所有患者（n=35）的坏疽没有进一步进展。RUDI术后瘘管流速降低57.5%(682±121ml/min,p值：0.001）。数字收缩压改善了71.4%(60±9.2mmHg，p值：0.002）RUDI后。双尺动脉收缩期峰值速度增加(66.1±8.2cm/s,p值：0.04）和径向（64.2±7.6cm/s，p值：0.024）腕部动脉。RUDI移植物的累积通畅率为100％，91.4%,在3、6和12个月时为85.7%，分别。结论：RUDI在DASS症状方面有显著改善。使用天然静脉作为导管，RUDI应被视为高流量DASS患者的首选程序。
