Abstract：
UNASSIGNED: Arteriovenous grafts (AVGs) serve as an alternative to native arteriovenous fistulas (AVFs) in the context of hemodialysis patient life planning. AVGs are more susceptible to developing outflow stenosis (due to intimal hyperplasia), thrombosis, and infections. However, an often overlooked contributor to AVG failure is cannulation damage. The objective of this paper is to assess the impact of cannulations on AVGs. We aim to establish a classification of AVG damage by comparing clinical data and ultrasound images with microscopic morphological findings obtained from explanted grafts.
UNASSIGNED: This study is conducted at a single center. We included all patients who underwent AVG creation between 2011 and 2019. Comprehensive data on clinical history, follow-up, and complications were collected and reviewed. Duplex ultrasound (DUS) characteristics were documented, and all grafts explanted during the analysis period underwent optical microscopy evaluation. Finally, clinical data, along with DUS and microscopic findings, were integrated to derive a damage classification.
UNASSIGNED: During the study period, 247 patients underwent 334 early cannulation AVGs. The median follow-up duration was 714 days (IQR 392, 1195). One hundred eleven (33%) grafts were explanted. Clinical data and DUS findings were utilized to formulate a four-grade classification system indicating increasing damage.
UNASSIGNED: Cannulation damage alone does not solely account for AVG failure. It results from a biological host-mediated process that promotes the growth of intimal hyperplasia at the cannulation sites. This process is not clinically significant within the initial 2 years after AVG creation.
UNASSIGNED: This study is conducted at a single center. We included all patients who underwent AVG creation between 2011 and 2019. Comprehensive data on clinical history, follow-up, and complications were collected and reviewed. Duplex ultrasound (DUS) characteristics were documented, and all grafts explanted during the analysis period underwent optical microscopy evaluation. Finally, clinical data, along with DUS and microscopic findings, were integrated to derive a damage classification.
UNASSIGNED: During the study period, 247 patients underwent 334 early cannulation AVGs. The median follow-up duration was 714 days (IQR 392, 1195). One hundred eleven (33%) grafts were explanted. Clinical data and DUS findings were utilized to formulate a four-grade classification system indicating increasing damage.
UNASSIGNED: Cannulation damage alone does not solely account for AVG failure. It results from a biological host-mediated process that promotes the growth of intimal hyperplasia at the cannulation sites. This process is not clinically significant within the initial 2 years after AVG creation.
摘要：
■在血液透析患者的生活计划中，动静脉移植物（AVG）可替代天然动静脉瘘（AVF）。AVG更容易发生流出道狭窄（由于内膜增生），血栓形成,和感染。然而,AVG失败的一个经常被忽视的原因是插管损伤。本文的目的是评估插管对AVG的影响。我们的目标是通过比较临床数据和超声图像与从移植移植物获得的微观形态学发现来建立AVG损伤的分类。
■这项研究是在单个中心进行的。我们纳入了2011年至2019年期间接受AVG创建的所有患者。临床病史的综合数据，后续行动,收集并审查并发症。记录了双重超声（DUS）特征，并且在分析期间移植的所有移植物都接受了光学显微镜评估。最后,临床资料,连同DUS和微观发现，被整合以得出损伤分类。
■在研究期间，247例患者接受334例早期插管AVG。中位随访时间为714天（IQR392，1195）。移植了111个（33％）移植物。临床数据和DUS发现被用来制定一个四级分类系统，表明损伤增加。
■仅套管损坏并不能完全解释AVG故障。它是由生物宿主介导的过程引起的，该过程促进了插管部位内膜增生的生长。该过程在AVG产生后的最初2年内没有临床意义。
■这项研究是在单个中心进行的。我们纳入了2011年至2019年期间接受AVG创建的所有患者。临床病史的综合数据，后续行动,收集并审查并发症。记录了双重超声（DUS）特征，并且在分析期间移植的所有移植物都接受了光学显微镜评估。最后,临床资料,连同DUS和微观发现，被整合以得出损伤分类。
■在研究期间，247例患者接受334例早期插管AVG。中位随访时间为714天（IQR392，1195）。移植了111个（33％）移植物。临床数据和DUS发现被用来制定一个四级分类系统，表明损伤增加。
■仅套管损坏并不能完全解释AVG故障。它是由生物宿主介导的过程引起的，该过程促进了插管部位内膜增生的生长。该过程在AVG产生后的最初2年内没有临床意义。
