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Comparison between bovine carotid artery graft and polytetrafluoroethylene graft for haemodialysis vascular access: A systematic review and meta-analysis.

牛颈动脉移植物和聚四氟乙烯移植物用于血液透析血管通路的比较: 系统综述和荟萃分析。

  • 影响因子:1.12
  • DOI:10.1177/1129729820926088
  • 作者列表:"Kostakis ID","Loukopoulos I
  • 发表时间:2021-01-01
Abstract

BACKGROUND:There is a renewed interest in using bovine carotid artery grafts for haemodialysis vascular access after recent advances in conduit manufacturing and endovascular management of access-related complications. Our aim was to summarize the results of the recent studies comparing bovine carotid artery grafts with polytetrafluoroethylene grafts as vascular access for haemodialysis. METHODS:A systematic review was conducted for original articles comparing bovine carotid artery with polytetrafluoroethylene grafts for haemodialysis vascular access published between January 2000 and December 2019 searching the databases of Medline, Scopus, Google Scholar, ClinicalTrials.gov and the Cochrane Central Register of Controlled Trials. RESULTS:Four studies were included (one prospective randomized controlled trial and three retrospective studies) with 676 patients in total (bovine carotid artery: 395, polytetrafluoroethylene: 281). There was lower graft infection rate per patient-year in bovine carotid artery grafts (mean difference: -0.03, p < 0.0001). Bovine carotid artery grafts required fewer interventions per patient-year to maintain or restore patency (mean difference: -0.81, p = 0.002). No significant difference was detected regarding pseudoaneurysm formation (p = 0.24), steal syndrome (p = 0.11) or patency rates (primary: 1 year: p = 0.15, 2 years: p = 0.69; primary assisted: 1 year: p = 0.18, 2 years: p = 0.54; secondary: 1 year: p = 0.22, 2 years: p = 0.17). CONCLUSION:Bovine carotid artery and polytetrafluoroethylene grafts have similar short-term and long-term outcomes, with a possible advantage of bovine carotid artery grafts concerning graft infections and number of required interventions. Thus, bovine carotid artery grafts can be a useful alternative modality for haemodialysis vascular access.

摘要

背景: 在导管制造和血管内治疗血管相关并发症方面的最新进展之后,使用牛颈动脉移植物进行血液透析血管通路的兴趣重新高涨。我们的目的是总结最近的研究结果,比较牛颈动脉移植物与聚四氟乙烯移植物作为血液透析的血管通路。 方法: 对2000年1月至2019年12月发表的比较牛颈动脉和聚四氟乙烯移植物用于血液透析血管通路的原始文章进行系统综述,检索Medline,Scopus,Google Scholar,clinicaltrials.Gov和Cochrane Central Register of Controlled Trials数据库。 结果: 共纳入4项研究 (1项前瞻性随机对照试验和3项回顾性研究),共676例患者 (牛颈动脉: 395,聚四氟乙烯: 281)。牛颈动脉移植物每患者年的移植物感染率较低 (平均差异: -0.03,p <0.0001)。牛颈动脉移植物每患者年需要较少的干预措施来维持或恢复通畅 (平均差: -0.81,p = 0.002)。假性动脉瘤形成 (p = 0.24) 、盗血综合征 (p = 0.11) 或通畅率 (主要: 1年: p = 0.15,2年: p = 0.69; 主要辅助: 1年: p = 0.18,2年: p = 0.54; 次要:1年: p = 0.22,2年: p = 0.17)。 结论: 牛颈动脉和聚四氟乙烯移植物具有相似的短期和长期结果,牛颈动脉移植物的优势可能在于移植物感染和所需干预的数量。因此,牛颈动脉移植物可以是用于血液透析血管通路的有用的替代方式。

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