Prevalence and functional profile of unsuspected radial artery stenosis in native radiocephalic fistula dysfunction. Diagnosis by vascular access flow monitoring using Delta-H method
Prevalencia y perfil funcional de la estenosis de la arteria radial. Diagnóstico mediante la monitorización del flujo sanguíneo de la fístula arteriovenosa radiocefálica para hemodiálisis utilizando el método Delta-H sanguíneo de la fístula arteriovenosa
R. Roca-Tey, O. Ibrik, R. Samon, R. Martínez-Cercós*, J.Viladoms
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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. 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Gutiérrez, J.Lahera" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:8 [ "pii" => "X0211699506020343" "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/X0211699506020343?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251406020340?idApp=UINPBA000064" "url" => "/20132514/0000002600000005/v0_201502091552/X2013251406020340/v0_201502091552/en/main.assets" ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Prevalence and functional profile of unsuspected radial artery stenosis in native radiocephalic fistula dysfunction. Diagnosis by vascular access flow monitoring using Delta-H method" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "581" "paginaFinal" => "586" ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. Roca-Tey, O. Ibrik, R. Samon, R. Martínez-Cercós*, J.Viladoms" "autores" => array:1 [ 0 => array:1 [ "nombre" => "R. Roca-Tey, O. Ibrik, R. Samon, R. Martínez-Cercós*, J.Viladoms" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Prevalencia y perfil funcional de la estenosis de la arteria radial. Diagnóstico mediante la monitorización del flujo sanguíneo de la fístula arteriovenosa radiocefálica para hemodiálisis utilizando el método Delta-H sanguíneo de la fístula arteriovenosa" ] ] "tienePdf" => false "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec436460" "palabras" => array:1 [ 0 => "Estenosis arteria radial, monitorización de fístula radiocefálica, método Delta-H, Crit-Line III" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "RESUMEN OBJETIVO. Conocer la prevalencia y perfil funcional de la estenosis de la arteria radial (AR) diagnosticada mediante la aplicación de un programa de monitorización del acceso vascular (AV). MATERIAL Y MÉTODOS. Hemos monitorizado prospectivamente durante 4 años el flujo sanguíneo (QA) de 116 AV (fístula arteriovenosa 81% o prótesis 19%; duración del AV 28.2¿52.9 meses) en 102 pacientes (pts) (edad 63.0¿13.0 años; sexo H: 56.9%, M: 43.1%; tiempo en hemodiálisis HD 31.4¿44.0 meses; 15.5% diabetes). El QA se determinó durante la HD cada 4 meses como mínimo mediante el método Delta-H utilizando el monitor Crit-Line III (QA global 1193.4¿490.3 ml/min). Cuarenta y tres AV (37%) presentaron evaluación positiva (QA absoluto <700 ml min: 48 8 61649 qa 20% respecto al valor basal: 51.2%) y se remitieron para efectuar angiografía. La mayoría de AV explorados por angiografía presentaron estenosis¿50% (36/40, 90%) que se localizó en la arteria nutricia 30.5% (11/36: todos los casos en fístulas radiocefálicas FRC) ó vena eferente 69.5% (25/36: vena arterializada VA de 14 FRC y 7 fístulas humerales; anastomosis venosa de 4 prótesis). RESULTADOS. Once casos de estenosis de la AR (prevalencia: 11/36, 30.5%; grado medio: 83.5¿15.8%) se diagnosticaron en 11 FRC (duración del AV 48.9¿76.7 meses) en 11 pts (edad 67.5¿11.5 años; tiempo en HD 54.0¿75.8 meses; 18.2% diabetes). Causa de evaluación positiva: QA absoluto <700 ml min 81 8 61649 qa 20% respecto al valor basal 8.2%. QA medio de la FRC justo antes de la angiografía: 532.9¿99.8 ml/min (intervalo, 418-699 ml/min). Clasificación de la estenosis: Tipo I (estenosis múltiple) 9.1%, tipo II (estenosis única pero crítica >90-95% que altera la hemodinámica normal de la FRC) 36.4% y tipo III (estenosis única entre el 50 y el 90%) 54.5%. Seguimiento: estenosis no reparable 36.4% (4/11), intervención electiva mediante cirugía 36.4% (4/11), exitus (2/11) ó trasplante (1/11) antes de la intervención 27.3%. El QA medio de la FRC tiende a aumentar desde 547.0¿100.6 ml/min justo antes de la cirugía hasta 872.3¿526.5 ml/min justo después de la cirugía (n=4, ¿QA=325.2¿431.3 ml/min) (p=0.068). Estudio comparativo con 14 estenosis de la VA (grado medio 76.4¿7.4%) de 11 FRC (duración del AV 16.4¿22.8 meses) en 11 pts (edad 64.3¿10.5 años; tiempo en HD 17.0¿18.9 meses; 50% diabetes): alta prevalencia de intervención (85.8%) en relación con los casos de estenosis de la AR (p=0.011); sin diferencias en el grado de estenosis (p=0.12), ¿QA (p=0.20) ni en el QA antes de la angiografía (p=0.78) y de la cirugía (p=1.00); el QA se incrementó significativamente después de la cirugía (n=6, 549.8¿86.4 vs 1033.0¿216.6 ml/min) (p=0.028). CONCLUSIONES. 1) Un tercio de los casos de disfunción de la AV se deben a la afectación de la arteria nutricia. 2) No hemos encontrado diferencias en el perfil funcional al comparar los casos de estenosis de la AR y de la VA antes de la angiografía y de la cirugía. 3) Los resultados funcionales de la cirugía electiva de la estenosis de la AR son peores en relación con los de la estenosis de la VA. </700> </700>" ] "en" => array:1 [ "resumen" => "SUMMARY Objective: The aim of this study was to know the prevalence and functional profile of RA stenosis in RCF dysfunction detected as a result of our surveillance programme. Patients and methods: We prospectively monitored QA of 116 VA (arteriovenous fistula 81% or graft 19%; mean VA duration 28.2 ± 52.9 months) during hemodiaysis (HD) in 102 ESRD (mean age 63.0 ± 13.0 yr; sex M: 56.9%, F: 43.1%; mean time on HD 31.4 ± 44.0 months; 15.5% diabetes) patients (pts) over 4 yr period. QA was measured at least every 4 months by the Delta-H method using the Crit-Line III monitor (overall mean QA 1,193.4 ± 490.3 ml/min) Forty-three VA (43/116, 37%) met criteria of positive evaluation (absolute QA < 700 ml/min: 48.8%; ÑQA > 20% from baseline: 51.2%) and were referred for angiography. Most VA explored by angiography showed stenosis 350% (36/40, 90%) that were mainly located in RCF (25/36, 69.4%: RA 11/25, arterialized vein AV 14/25). Results: Eleven cases of RA stenosis (prevalence: 11/36, 30.5%; mean degree: 83.5 ± 15.8%) were found in 11 RCF (mean VA duration 48.9 ± 76.7 months) of 11 pts (mean age 67.5 ± 11.5 yr; mean time on HD 54.0 ± 75.8 months; 18.2% diabetes). Cause of positive evaluation: absolute QA < 700 ml/min 81.8%; ÑQA > 20% from baseline 18.2%. Mean QA of RCF just before angiography: 532.9 ± 99.8 ml/min (range, 418-699 ml/min). Stenosis type: Type I (multiple stenoses) 9.1%, type II (isolated stenosis but critical > 90-95%) 36.4% and type III (isolated stenosis 50-90% with normal haemodynamic status of RCF) 54.5%. Followup: stenosis not reparable 36.4% (4/11), elective intervention by surgery 36.4% (4/11), lost of follow-up before intervention 27.3% (2/11 died, 1/11 transplantation). Mean QA of RCF tended to increase from 547.0 ± 100.6 ml/min just before surgery to 872.3 ± 526.5 ml/min just after surgery (n = 4, mean DQA = 325.2 ± 431.3 ml/min (p = 0.068). Comparative study with 14 AV stenosis (mean degree 76.4 ± 7.4%) in 11 RCF (mean VA duration 16.4 ± 22.8 months) of 11 pts (mean age 64.3 ± 10.5 yr; mean time on HD 17.0 ± 18.9 months; 50% diabetes): higher prevalence of intervention (85.8%) compared to RA stenosis (p =0.011); without differences in degree of stenosis (p = 0.12) and QA before angiography (p = 0.78) or surgery (p = 1.00); mean QA increased significantly after surgery (n = 6 AV, 549.8 ± 86.4 vs 1,033.0 ± 216.6 ml/min) (p = 0.028). Conclusions: 1) One third of cases of VA dysfunction were related to feeding artery stenosis. 2) No differences in functional profile were found between RA and AV stenosis before angiography and surgery. 3) The functional results of elective surgery in RA stenosis were worse compared to AV stenosis. " ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002600000005/v0_201502091552/X2013251406020375/v0_201502091552/en/main.assets" "Apartado" => null "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251406020375?idApp=UINPBA000064" ]
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ISSN: 20132514Original language: English
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