Collateral Vein Ligation for Arteriovenous Fistula Maturation: A Pilot Study

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum Pub Date : 2025-01-01 DOI:10.1016/j.ejvsvf.2025.03.001

Bogdan Bratu , Bettina Chenesseau , Andreea Luchianov , Salomé Kuntz , Nabil Chakfé , Anne Lejay

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Abstract

Objectives

Native arteriovenous fistulae (AVF) may fail to achieve adequate blood flow or size for successful cannulation and dialysis. No clear strategy exists concerning the effectiveness of collateral vein ligation (CVL) to improve AVF maturation. The aim of this study was to evaluate the effectiveness of CVL in improving AVF maturation.

Methods

A retrospective study was performed, including all patients who underwent CVL for delayed AVF maturation between January 2023 and December 2023. Combined procedures, such as concomitant venous stenosis angioplasties, were excluded. Evolution of AVF flow after CVL compared with AVF flow before CVL was recorded. The primary endpoint was defined as successful maturation after CVL. The AVF was considered mature when it could be routinely cannulated for the total duration of dialysis, for at least six months.

Results

Median follow up was eleven months (range 6–14 months). CVL allowed successful maturation in five of the six patients, with a median AVF flow increase of 44%. In these five patients, sustained dialysis after CVL was uneventful, without need for any additional interventions.

Conclusion

These results highlight the potential effectiveness of CVL in improving AVF maturation, although larger studies are needed to confirm these findings.

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侧静脉结扎术治疗动静脉瘘成熟：一项初步研究

目的：原生动静脉瘘（AVF）可能无法获得足够的血流或大小，无法成功插管和透析。关于侧静脉结扎（CVL）提高AVF成熟的有效性尚无明确的策略。本研究的目的是评估CVL在促进AVF成熟方面的有效性。方法回顾性研究，纳入2023年1月至2023年12月期间因AVF成熟延迟而行CVL的所有患者。排除联合手术，如合并静脉狭窄血管成形术。记录了CVL后与CVL前AVF流动的演变。主要终点被定义为CVL后的成功成熟。当AVF能够在整个透析期间常规插管至少6个月时，就被认为是成熟的。结果中位随访时间为11个月（6 ~ 14个月）。CVL使6例患者中的5例成功成熟，中位AVF流量增加44%。在这5例患者中，CVL后持续透析是平稳的，不需要任何额外的干预。这些结果强调了CVL在促进AVF成熟方面的潜在有效性，尽管需要更大规模的研究来证实这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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