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首页> 外文期刊>Vascular and endovascular surgery >Anastomotic strategies to improve hemodialysis access patency--a review.
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Anastomotic strategies to improve hemodialysis access patency--a review.

机译：改善血液透析通畅性的吻合策略-综述。

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摘要

The number of patients with end-stage renal disease (ESRD) who require maintenance hemodialysis has risen sharply in the past 2 decades. It is estimated that more than 60% of all patients with ESRD who require chronic hemodialysis are accessed through an arteriovenous fistula (AVF) or graft (AVG), and the incidence is increasing at a rate of 2% to 4% per year. The long-term patency rate of an upper extremity AVF or AVG for hemodialysis access remains suboptimal owing in part to progressive stenosis at the venous anastomosis. This article reviews the causative factors of dialysis access-related anastomotic stenosis, or intimal hyperplasia. This article also reviews the clinical experience of various anastomotic strategies to ameliorate the hemodynamic environment in an effort to improve the clinical outcome of hemodialysis access. These strategies include the use of (1) vein cuff at the expanded polytetrafluoroethylene (ePTFE)-venous anastomosis of AVG, (2) cuffed ePTFE dialysis AVG, and (3) anastomoticdevices that create an interrupted anastomosis with staples or clips.
机译：在过去的20年中，需要维持性血液透析的终末期肾病（ESRD）患者数量急剧上升。据估计，所有需要进行慢性血液透析的ESRD患者中，有60％以上是通过动静脉瘘（AVF）或移植物（AVG）进行治疗的，并且发病率每年以2％至4％的速度递增。上肢AVF或AVG进行血液透析的长期通畅率仍然欠佳，部分原因是静脉吻合处的进行性狭窄。本文回顾了与透析通路相关的吻合口狭窄或内膜增生的原因。本文还回顾了改善血液动力学环境的各种吻合策略的临床经验，以改善血液透析的临床效果。这些策略包括（1）在扩张的聚四氟乙烯（ePTFE）-AVG静脉吻合处使用静脉套囊;（2）进行ePTFE透析的袖带化手术;以及（3）用钉书钉或夹子产生间断吻合的吻合装置。

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