Vaivt間隔の長短によらずステントグラフトは有効である

Abstract

Keywords： hemodialysis, arteriovenous graft, stent graft implantation, vascular access intervention therapy 〈Abstract〉 We conducted a study to determine the optimal timing for treating arteriovenous graft (AVG) outflow tract stenosis by comparing intervention intervals pre and post stent graft implantation. This study included cases of stent graft implantation for upper limb AVG outflow tract stenosis in our department from August 2020 to December 2022. We compared the mean number of days between the three VAIVT sessions before stent graft implantation (Pre SG) and the first VAIVT session after stent graft implantation (Post SG). The median Pre SG in all 31 patients was 98 days (interquartile range： 61 to 146 days) and the median Post SG was 403 days (195 to 539 days), which represents a significant fourfold increase in VAIVT intervals (p ＜0.05). However, in three cases, Post SG was shorter than Pre SG. To ensure long term patency after stent graft implantation, it is important to select a large diameter, more central vein with a high patency rate as the site of AVG placement from the beginning, to ensure complete coverage of the target lesions, and use the elephant trunk technique.