Polytetrafluoroethylene segment implantation for arteriovenous internal fistula with outflow tract obstruction

doi:10.3969/j.issn.2095-4344.2014.30.025

Abstract

Abstract:

BACKGROUND: Arteriovenous internal fistula is the first choice for hemodialysis. In the process of hemodialysis, many patients suffer from venous outflow stenosis. The methods including thrombolysis, intervention, surgical repair and fistula reconstruction all have their disadvantages.
OBJECTIVE: To compare the midterm effects of polytetrafluoroethylene segment implantation and exclusively surgical repair in arteriovenous internal fistula with outflow tract obstruction.
METHODS: Eighty patients with venous outflow stenosis, aged 22-80 years, were divided into test group (n=50; polytetrafluoroethylene segment implantation) and control group (n=30; simple surgical repair). The post-operative infection rate, postoperative time till recurrence of fistula dysfunction, and accumulate survival rate were compared between the two groups.
RESULTS AND CONCLUSION: During the follow-up period of 10-28 months in the test group, there were nine patients with vascular access dysfunction, and the accumulate survival rate was 100% for 6 postoperative months, 92% for 12 months, and 82% for 18 months. In the control group, there were seven cases of vascular access dysfunction at 8-28 months of follow-up, and the accumulate survival rate was 93% for 6 postoperative months, 87% for 12 months, and 77% for 18 months. No statistically significant difference in the postoperative infection rate was observed between the two groups. The Kaplan-Meier survival curves showed that the accumulate survival rate was slightly higher in the test group than the control group, but there was no significant difference based on log-rank test (P=0.44). These findings indicate that polytetrafluoroethylene segment implantation for arteriovenous internal fistula with outflow tract obstruction has the similar effects as the surgical repair if it does not alter the autologous behavior of the initial access and maximally reserve the vessels for puncture.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: blood vessel prosthesis, uremia, renal dialysis

CLC Number:

R318

Zhang Yu, Zhu Zhi-qiang, Zheng Xin, Ma Xue-tao, Liu Jian-wei, Han Zhi-you . Polytetrafluoroethylene segment implantation for arteriovenous internal fistula with outflow tract obstruction[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(30): 4911-4916.

Figures/Tables 2

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