METHODS: All one-staged BBAVF and AS-AVG from August 2014 to December 2019 were reviewed. In cases of suitable basilic vein of 3 mm or more present from cubital crease to axilla, one-staged BBAVF was preferred. AS-AVG was performed for patients who need timely functioning access or have no suitable basilic vein.
RESULTS: Twenty-eight one-staged BBAVF and 74 AS-AVG were included. Baseline characteristics were not significantly different, except AS-AVG had less previous ipsilateral access (9% vs 39%; p < .001). Postoperative complications were not different. With six loss follow-ups (3 in BBAVF and 3 in AS-AVG), 24 (96%) and 64 (90%) matured after one-staged BBAVF and AS-AVG, respectively (p = .676). BBAVF took about 30 days (95% CI: 10, 51) longer time to first successful cannulation. Primary patency was significantly better for one-staged BBAVF (hazard ratio (HR) of 3.0 (95%CI: 1.2, 7.7)), whereas secondary patency was not different. The total access failure (i.e. failure to mature combined with any thrombosis or intervention to maintain patency) significantly favored BBAVF (HR 2.7 (95%CI: 1.1, 6.6)).
CONCLUSIONS: Provided a suitable arm basilic vein is available, one-staged BBAVF is preferred over AS-AVG when forearm AVF, forearm AVG, and arm cephalic veins are out. However, it requires a longer time to start cannulating than AS-AVG.
方法:回顾了2014年8月至2019年12月的所有一期BBAVF和AS-AVG。如果从肘部折痕到腋窝存在3毫米或更大的合适的贵重静脉,一级BBAVF是首选。AS-AVG适用于需要及时有效通路或没有合适贵重静脉的患者。
结果:包括28个一期BBAVF和74个AS-AVG。基线特征无显著差异,除了AS-AVG之前的同侧通路较少(9%vs39%;p<.001)。术后并发症无差异。有6次损失随访(BBAVF3次,AS-AVG3次),24(96%)和64(90%)在一级BBAVF和AS-AVG后成熟,分别(p=.676)。BBAVF花费了约30天(95%CI:10,51)的更长时间来首次成功插管。一级BBAVF的主要通畅性显着更好(危险比(HR)为3.0(95CI:1.2,7.7)),而继发性通畅性没有差异。总的通路失败(即未能成熟结合任何血栓形成或维持通畅的干预)显著有利于BBAVF(HR2.7(95CI:1.1,6.6))。
结论:只要有合适的手臂贵重静脉,当前臂AVF时,一级BBAVF优于AS-AVG,前臂AVG,手臂头静脉都出来了.然而,它需要比AS-AVG更长的时间来开始插管。