Comparative study of PTFE grafts in forearm vs cuffed permanent catheters
ESTUDIO COMPARATIVO DEL USO DE PRÓTESIS VASCULARES DE PTFE A NIVEL DE ANTEBRAZO vs CATÉTER PERMANENTE
M.J. Moyano , M. Salgueira , N. Aresté , B. Escalera , N. del Toro , E. Jiménez-Víbora , A.I. Martínez-Puerto , J.R. Molas , A. Palma
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Comparative analysis of the mechanical vehaviour of native vessels and prosthesis" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "587" "paginaFinal" => "593" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "ACCESOS VASCULARES PARA HEMODIÁLISIS: ANÁLISIS COMPARATIVO DEL COMPORTAMIENTO MECANICO DE VASOS NATIVOS Y PRÓTESIS" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "D. Bia, Y. Zócalo, H. Pérez, M. Saldías, W. Silva, I. Alvarez, C. Galli, E. Cabrera, R. Armentano" "autores" => array:1 [ 0 => array:1 [ "nombre" => "D. Bia, Y. Zócalo, H. Pérez, M. Saldías, W. Silva, I. Alvarez, C. Galli, E. Cabrera, R. Armentano" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:8 [ "pii" => "X021169950602036X" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X021169950602036X?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251406020367?idApp=UINPBA000064" "url" => "/20132514/0000002600000005/v0_201502091552/X2013251406020367/v0_201502091552/en/main.assets" ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Comparative study of PTFE grafts in forearm vs cuffed permanent catheters" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "594" "paginaFinal" => "599" ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.J. Moyano , M. Salgueira , N. Aresté , B. Escalera , N. del Toro , E. Jiménez-Víbora , A.I. Martínez-Puerto , J.R. Molas , A. Palma" "autores" => array:1 [ 0 => array:1 [ "nombre" => "M.J. Moyano , M. Salgueira , N. Aresté , B. Escalera , N. del Toro , E. Jiménez-Víbora , A.I. Martínez-Puerto , J.R. Molas , A. Palma" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "ESTUDIO COMPARATIVO DEL USO DE PRÓTESIS VASCULARES DE PTFE A NIVEL DE ANTEBRAZO vs CATÉTER PERMANENTE" ] ] "tienePdf" => false "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec436462" "palabras" => array:1 [ 0 => "acceso vascular; catéter permanente; diálisis adecuada; prótesis de PTFE" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "La fístula arteriovenosa (FAV) autóloga es el acceso vascular permanente de elección en los pacientes en hemodiálisis. Cuando esta opción no es posible, se debería optar por una prótesis vascular de politetrafluoroetileno (PTFE) y en tercer lugar por un catéter permanente tunelizado (CPT). OBJETIVO: Comparar la incidencia de complicaciones, morbilidad, índices de eficacia dialítica, así como la supervivencia de los CPT vs PTFE a nivel de antebrazo. MATERIAL Y MÉTODOS: Estudiamos retrospectivamente 81 accesos vasculares realizados en 59 pacientes, seguidos desde Octubre-99 hasta Diciembre-03. Dividimos la muestra en dos grupos en función del acceso vascular: G-I (n=42) CPT; G-II (n=39) PTFE. Se compararon características clínicas, índice de comorbilidad (Wright y Kanh), eficacia de diálisis, complicaciones y supervivencia. RESULTADOS: No encontramos diferencias significativas en cuanto a los datos antropométricos, tiempo en hemodiálisis, número de accesos previos o el número de ingresos en relación al acceso vascular. Los pacientes portadores de PTFE presentaban un índice de comorbilidad inferior a los portadores de CPT o de ambos accesos. El flujo obtenido con las prótesis de PTFE era superior al obtenido con los CPT (p=0,003). La albúmina era más elevada en el grupo de las prótesis de PTFE (p=0,002). El número de complicaciones fue superior en el grupo de los injertos (p < 0,05), siendo la trombosis la más frecuente. Durante el seguimiento hubo que retirar más prótesis que CPT (p <0 000 siendo el motivo más frecuente de pérdida del acceso vascular la trombosis seguido infección supervivencia acumulada a 35 meses seguimiento analizada mediante curvas kaplan-meier mostró una mayor cpt 61 4 frente prótesis ptfe 9 8 p <0 01 conclusiones: los cpt mostraron menor incidencia de complicaciones y mayor supervivencia que las prótesis ptfe a pesar haber sido colocados en más la mitad casos pacientes con una comorbilidad el principal motivo fracaso del acceso vascular fue trombosis seguido infección se retiraron finalmente parámetros eficacia diálisis fueron similares ambos grupos</0> </0>" ] "en" => array:1 [ "resumen" => "Introduction: As is universally accepted the best form of permanent vascular access for haemodialysis is the native arteriovenous fistula. A second and third options are the politetrafluoroethylene (PTFE) AV grafts and the cuffed, tunneled, internal catheters. The overall performance and complications of catheters is clearly inferior to AV fistula. There are not many studies that compare permanent catheters to grafts in terms of functionality, survival and complications. Methods: We analyzed 81 vascular accesses carried out from october 99 to december 03 in 59 patients and during a follow-up period of 35 months. Two groups were considered. Group 1, catheters (n 42) and group 2, grafts (n 39). Clinical aspects, comorbidity index (Wright and Kanh), dialysis dose and complications and survival of the access were registered. Results: Both groups were similar in age, sex, time on haemodialysis, number of previous accesses and hospitalization days. Cardiovascular morbidity and comorbidity index were significantly higher in patients with catheter. While blood flow during dialysis was higher in grafts both groups showed no significant differences in parameters of efficacy of dialysis (Kt/V, TAC BUN and PCRn). Serum albumin was lower in patients with catheter. The number of accesses that failed was higher in the graft group being thrombosis the main complication followed by infection. Kaplan-Meier curves showed better accumulated survival of permanent catheters versus grafts (61,4% vs 9,8% at 35 months). The most frequent complication of catheter was infection while in the case of grafts it was thrombosis followed by infection. Conclusions: Although they were placed in patients with higher comorbidity, cuffed, tunneled catheters showed less number of complications and better survival than PTFE grafts in our patients in haemodialysis. The main cause of failure of both vascular access was thrombosis followed by infection. The dose of dialysis obtained was no different in both groups. Cuffed, tunneled permanent catheters are a very interesting option in a number of patients in haemodialysis and they can be an option to consider in those patients with vascular difficulties and higher comorbidities." ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002600000005/v0_201502091552/X2013251406020324/v0_201502091552/en/main.assets" "Apartado" => null "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251406020324?idApp=UINPBA000064" ]
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ISSN: 20132514Original language: English
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