인조혈관 동정맥루의 기능부전시 니티놀 스텐트와 풍선확장술의 비교 = Comparison of a Nitinol Stent versus Balloon Angioplasty for Treatment of a Dysfunctional Arteriovenous Graft

다국어 초록 (Multilingual Abstract)

Purpose: This study aimed to 1) evaluate the outcome of placing a nitinol stent for treating dysfunctional arteriovenous grafts (AVG), and 2) compare the results with those of successful balloon angioplasty.
Materials and Methods: Between February 2008 and October 2011, we retrospectively reviewed the interventional data and medical records of 29 patients (21 men, 8 women; mean age, 67.4 years) who underwent interventional procedures for dysfunctional AVG. Stents were placed only in cases with inadequate angioplasty results. Stent patency was evaluated and compared to cases of successful balloon angioplasty using the Kaplan-Meier analysis.
Results: Eleven stents and 18 angioplasties were performed successfully at the venous anastomotic site of AVG. The primary patency at 3, 6, 12, and 18 months did not differ significantly for stent placement and angioplasty (52%, 29%, 15%, 15% vs. 71%, 50%, 34%, 34%; mean survival, 164 vs. 253 days, p = 0.283). Secondary patency of the stent also did not differ significantly from angioplasty (80%, 80%, 49%, 49% vs. 76%, 57%, 57%, 36%; mean survival, 405 vs. 385 days, p = 0.553).
Conclusion: Nitinol stent placement was effective for treating dysfunctional AVG, but did not improve the primary and secondary patency compared to successful angioplasty.

국문 초록 (Abstract)

목적: 인조혈관 동정맥루의 기능부전 치료에 니티놀 스텐트의 성적를 알아보고 성공적인 풍선확장술과 비교를 하고자 한다.
대상과 방법: 2008년 2월부터 2011년 10월까지 인조혈관 동정맥루의 기능부전으로 내원하여 인터벤션 시술을 시행받은 29명의 환자(남자 21, 여자 8; 평균연령 67.4세)의 시술기록지와 투석기록을 후향적으로 분석하였다. 스텐트는 풍선확장술이 불충분한 경우에 설치하였다. Kaplan-Meier 분석을 이용하여 스텐트의 개통률을 알아보고 성공적인 풍선확장술과 비교하였다.
결과: 인조혈관 동정맥루의 정맥문합부위에 11예의 스텐트와 18예의 풍선확장술을 성공적으로 시행하였다. 스텐트설치술과 풍선확장술의 3, 6, 12, 그리고 18개월의 일차개통률은 차이가 없었다(52%, 29%, 15%, 15% vs. 71%, 50%, 34%, 34%; 평균개통기간, 164 vs. 253일, p = 0.283). 이차개통률도 차이가 없었다(80%, 80%, 49%, 49% vs. 76%, 57%, 57%, 36%; 평균개통기간, 405 vs. 385 일, p = 0.553). 개통기간에 미치는 환자나 동정맥루의 인자는 없었다.
결론: 니티놀 스텐트는 인조혈관 동정맥루의 기능부전의 치료에 효과적이다. 그러나 성공적인 풍선확장술보다 일차 및 이차 개통기간을 향상시키지는 못하였다.

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