Abstract:
Objective: To evaluate the long-term outcomes of lower extremity arteriovenous graft (AVG) in hemodialysis patients. Methods: Hemodialysis patients with lower extremity AVG from August 2015 to July 2023 in the Department of Vascular Surgery, Longhua Hospital, Shanghai University of Traditional Chinese Medicine were enrolled. Therapeutic effects and complications of AVG were retrospectively analyzed. Results: A total of 83 cases aged (58.9±13.3) years were enrolled, including 25 males and 58 females. The success rate of the operation was 100% (83/83), and no perioperative complications occurred. The follow-up time [M (Q1, Q3)] was 38.4 (22.6, 55.3) months, with a follow-up rate of 92.8% (77/83). There were 9 cases (11.7%) of puncture site infection, 5 cases (6.5%) of pseudoaneurysm, 2 cases (2.6%) of seroma, 3 cases (3.9%) of lower limb ischemia, 48 cases (62.3%) of stenosis and 24 cases (31.2%) of thrombosis during the follow-up period. The 6-month, 1-year, 2-year, 3-year and 5-year primary patency rates after surgery were 78.9%, 61.2%, 39.0%, 27.0% and 16.3%, respectively, assisted primary patency rates were 93.5%, 82.5%, 74.9%, 68.0% and 53.0%, respectively, and secondary patency rates were 96.1%, 94.7%, 93.1%, 91.3% and 75.3%, respectively. Conclusion: For patients whose vascular resources of upper limbs are exhausted, lower extremity AVG is a safe and effective hemodialysis vascular access.
目的: 评价血液透析患者下肢动静脉移植物内瘘(AVG)的长期应用效果。 方法: 回顾性分析2015年8月至2023年7月上海中医药大学附属龙华医院血管外科下肢AVG患者的临床资料,分析其通畅率和并发症发生情况。 结果: 共纳入83例患者,男25例,女58例,年龄(58.9±13.3)岁,AVG手术成功率为100%(83/83),无围手术期并发症。随访时间[M(Q1,Q3)]38.4(22.6,55.3)个月,随访率92.8%(77/83)。术后穿刺点感染9例(11.7%),穿刺点假性动脉瘤5例(6.5%),血清肿2例(2.6%),下肢缺血3例(3.9%),狭窄48例(62.3%),其中24例(31.2%)继发血栓形成。Kaplan-Meier生存分析结果显示,术后6个月及1、2、3、5年初级通畅率分别为78.9%、61.2%、39.0%、27.0%、16.3%,初级辅助通畅率分别为93.5%、82.5%、74.9%、68.0%、53.0%,次级通畅率分别为 96.1%、94.7%、93.1%、91.3%、75.3%。 结论: 对于上肢血管资源耗竭的血液透析患者,下肢AVG是安全、有效的血管通路之一。.