Surgical Outcomes of Forearm Loop Arteriovenous Fistula Formation Using Tapered versus Non-Tapered Polytetrafluoroethylene Grafts

다국어 초록 (Multilingual Abstract)

Background: Tapered grafts, which have a smaller diameter on the arterial side, have been increasingly used for arteriovenous fistula (AVF) formation. We compared the outcomes of 4–6-mm tapered and 6-mm straight forearm loop arteriovenous grafts. Methods: A total of 103 patients receiving forearm loop arteriovenous grafts between March 2005 and March 2015 were retrospectively analyzed and separated into 2 groups (group A, 4- to 6-mm tapered grafts, n=78; group B, 6-mm straight grafts, n=25). In each group, complications and patency rates after surgery were assessed. Results: Clinical characteristics and laboratory results, except for cerebrovascular disease history (group A, 7.7%; group B, 28.0%; p=0.014), were similar between the groups. No significant differences were found for individual complications. Kaplan-Meier survival analysis revealed no significant differences in 1-year, 3-year, and 5-year patency rates between groups (61.8%, 44.9%, and 38.5% vs. 62.7%, 41.1%, and 35.3%, respectively). Conclusion: We found no significant differences in complication and patency rates between the tapered and straight graft groups. If there are no differences in complication and patency between the two graft types, tapered grafts may be a valuable option for AVF formation in light of their other advantages.

참고문헌 (Reference)

1 Papaioannou TG, "Vascular wall shear stress : basic principles and methods" 6 : 9-15, 2005

2 Suding PN, "Strategies for management of ischemic steal syndrome" 20 : 184-188, 2007

3 Polo JR, "Randomized comparison of 6-mm straight grafts versus 6-to 8-mm tapered grafts for brachial-axillary dialysis access" 40 : 319-324, 2004

4 Van Tricht I, "Hemodynamics in a compliant hydraulic in vitro model of straight versus tapered PTFE arteriovenous graft" 116 : 297-304, 2004

5 Dammers R, "Evaluation of 4-mm to 7-mm versus 6-mm prosthetic brachial-antecubital forearm loop access for hemodialysis : results of a randomized multicenter clinical trial" 37 : 143-148, 2003

6 ESRD Registry Committee, "Current renal replacement therapy in Korea" Korean Society of Nephrology

7 Vascular Access 2006 Work Group, "Clinical practice guidelines for vascular access" (48 Suppl 1) : S176-S247, 2006

8 Duk-Sil Kim, "Clinical Analysis of Hemodialysis Vascular Access: Comparision of Autogenous Arterioveonus Fistula & Arteriovenous Prosthetic Graft" 대한흉부외과학회 44 (44): 25-31, 2011

9 Park J, "Changes of cardiac function by the arteriovenous fistula in end stage renal failure patients" 14 : 309-315, 1998