颈内静脉血栓形成患者锁骨上臂头静脉和股静脉入路隧道式透析导管置入术的比较。

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Hemodialysis International Pub Date : 2023-10-05 DOI:10.1111/hdi.13117

Umut Oguslu, Burçak Gümüş, Murat Yalçin, Osman Zikrullah Sahin, Gökalp Yilmaz

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引用次数: 0

摘要

引言：对于双侧颈内静脉血栓形成的最佳进入途径仍存在争议。我们旨在比较经锁骨上臂头静脉和股静脉入路置入隧道透析导管治疗双侧颈内静脉血栓形成患者的安全性、有效性和结果。方法：在2018年1月至2021年12月期间，通过锁骨上臂头静脉放置隧道式透析导管的患者的数据（n = 42）和股静脉（n = 57）方法。注意患者人口统计学、技术和临床成功率、并发症和结果。Likert量表用于评估患者满意度。结果：42例（42.4%）患者为男性，平均年龄61.9岁（范围为12-93岁）。两组的技术和临床成功率均为100%。未发现重大并发症。平均随访时间为497.5（范围32-1698）导管天数。头臂静脉和股静脉组的30天通畅率相似（40[95.2%]对55[96.5%]，p = 0.754）。此外，原发性和累积性通畅率具有可比性（p = 0.158；p = 0.660）。头臂静脉和股静脉组的感染率分别为2.6和4.1‰。头臂静脉组的无感染生存率显著较高（71.9%对12岁时的35.3% 月，p 讨论：锁骨上臂头静脉和股静脉入路在技术和临床上都有很高的成功率，通畅率相当。然而，低感染率和高患者满意度使锁骨上臂头静脉在进入股静脉之前成为一种合理的选择。

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Comparison of supraclavicular brachiocephalic and femoral vein approaches for tunneled dialysis catheter placement in patients with thrombosed internal jugular veins

Introduction

There is still debate on the best access route in case of bilateral internal jugular vein thrombosis. We aimed to compare the safety, effectiveness, and outcomes of tunneled dialysis catheter placement via supraclavicular brachiocephalic and femoral vein approaches in patients with bilateral internal jugular vein thrombosis.

Methods

Between January 2018 and December 2021, data of the patients in whom tunneled dialysis catheters were placed via the supraclavicular brachiocephalic vein (n = 42) and femoral vein (n = 57) approaches were extracted. Patient demographics, technical and clinical success rates, complications, and outcomes were noted. The Likert scale was used to assess patient satisfaction.

Findings

Forty two (42.4%) patients were men, and the mean age was 61.9 (range, 12–93) years. The technical and clinical success rate was 100% for both groups. No major complication was encountered. The mean follow-up period was 497.5 (range, 32–1698) catheter days. Thirty-day patency was similar for the brachiocephalic vein and femoral vein group (40 [95.2%] vs. 55 [96.5%], p = 0.754). Also, primary and cumulative patency rates were comparable (p = 0.158; p = 0.660). The infection rate was 2.6 and 4.1 per 1000 catheter days for the brachiocephalic vein and femoral vein group. The infection-free survival was significantly higher in the brachiocephalic vein group (71.9% vs. 35.3% at 12 months, p < 0.001). Patient satisfaction was higher in the brachiocephalic vein group (median satisfaction, 5 vs. 4, p < 0.001).

Discussion

Both supraclavicular brachiocephalic vein and femoral vein approaches have high technical and clinical success with comparable patency rates. However, low infection rate and high patient satisfaction make the supraclavicular brachiocephalic vein approach a reasonable alternative before proceeding to the femoral vein access.

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来源期刊

Hemodialysis International UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.