Comparison of drug-eluting stents and percutaneous transluminal angioplasty in the treatment of autologous arteriovenous fistula stenosis

doi:10.3969/j.issn.1009-976X.2023.06.007

Abstract

Abstract: Objective To compare the efficacy and safety of drug-eluting stents（DES） and percutaneous transluminal angioplasty（PTA） in the treatment of autologous arteriovenous fistula（AVF） stenosis. Methods The clinical data of 87 patients with AVF stenosis and underwent surgery in our hospital from January 2018 to December 2022 were analyzed retrospectively. These patients were divided into PTA group（n=44） and DES group（n=43） according to operative method. The success rate of operation, postoperative diameter and dialysis blood flow of stenosis, primary patency rate at 6 and 12 months after operation and complications within one month after operation were compared between the two groups. Results The clinical success rates of all patients were 100%. The technical success rates of DES group and PTA group were 100% and 91.0%, respectively. The differences of postoperative diameter of stenosis and dialysis blood flow between the two groups were not statistically significant. The primary patency rates of 6 months of DES group and PTA group were 79.1% and 45.5%, respectively. The primary patency rate of 6 months of DES group was statistically superior to PTA group（P=0.001）. The primary patency rates of 12 months of DES group and PTA group were 30.2% and 9.1%, respectively. The primary patency rate of 12 months of DES group was statistically superior to PTA group（P=0.013）. There was no significant difference in the incidence of complications within 1 month after operation between the two groups. Conclusion DES is effective and safe for the treatment of AVF stenosis. Implantation of DES improves the primary patency rate compared with PTA only.

Key words: autologous arteriovenous fistula, percutaneous transluminal angioplasty, drug-eluting stents

摘要： 目的比较药物洗脱支架和球囊扩张治疗自体动静脉内瘘狭窄的效果和安全性。方法回顾性分析2018年1月至2022年12月在我院手术治疗的87例自体动静脉内瘘狭窄患者的临床资料,根据手术方式分为球囊扩张组44例和支架植入组43例,比较两组患者手术成功率及术后狭窄内径、透析血流量和术后6个月、12个月初级通畅率以及术后1个月内并发症发生率。结果所有患者临床成功率100%。支架植入组和球囊扩张组技术成功率分别为100%和91.0%。2组患者术后狭窄内径及透析血流量差异无统计学意义。支架植入组和球囊扩张组术后6个月初级通畅率分别为79.1%和45.5%,支架植入组6个月初级通畅率优于球囊扩张组,差异有统计学意义（P=0.001）。支架植入组和球囊扩张组12个月初级通畅率分别为30.2%和9.1%,支架植入组12个月初级通畅率优于球囊扩张组,差异有统计学意义（P=0.013）。两组患者术后1个月内并发症发生率差异无统计学意义。结论药物洗脱支架治疗自体动静脉内瘘狭窄安全、有效,与球囊扩张术相比,可以提高术后初级通畅率,为治疗动静脉内瘘狭窄提供一种新的选择。

关键词: 自体动静脉内瘘, 球囊扩张, 药物洗脱支架

CLC Number:

R654.3

ZOU Lan, ZHU Zheng-rong. Comparison of drug-eluting stents and percutaneous transluminal angioplasty in the treatment of autologous arteriovenous fistula stenosis[J]. Lingnan Modern Clinics In Surgery, 2023, 23(6): 485-489.

邹岚, 朱峥嵘. 药物洗脱支架和球囊扩张治疗自体动静脉内瘘狭窄的效果比较[J]. 岭南现代临床外科, 2023, 23(6): 485-489.

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