Clinical Research Articles
Early cannulation grafts versus standard polytetrafluoroethylene grafts for hemodialysis: a systematic review and meta-analysis
Zheng Lei, Zhao Hao, Ma Bo, Chen Jie, Zhang Jianbin, Ye Zhidong
Published 2021-05-31
Cite as Chin J Vasc Surg, 2021, 06(2): 116-123. DOI: 10.3760/cma.j.cn101411-20201213-00123
Abstract
ObjectiveTo compare the patency rate and the risk of related complications of early cannulation grafts and standard polytetrafluoroethylene (PTFE) grafts.
MethodsMEDLINE, Embase database, Cochrane library, CNKI, SinoMED and WANFANG Data were searched.Published papers on comparative study of early cannulation grafts and standard polytetrafluoroethylene (PTFE) grafts for hemodialysis till March 2021 were included. A meta-analysis was performed on the extracted data including primary and secondary patency rate, the incidence of infection, pseudo-aneurysm formation and cases of death during the follow-up. A fixed effects model was employed for the analysis based on the heterogeneity of the results.
ResultsA total of 10 papers were included in this study, including 2 randomized controlled studies and 8 observational studies, with 1069 cases of grafts in total. Compared with standard PTFE grafts, in early cannulation grafts there was no statistically significant difference in terms of the 12-month primary patency rate (HR=1.075, 95% CI: 0.871-1.327, P=0.501), the 18-month primary patency rate (HR=1.127, 95% CI: 0.910-1.395, P=0.273), the 24-month primary patency rate (HR=1.079, 95% CI: 0.793-1.470, P=0.628), cases of infection (OR=1.204, 95% CI: 0.765-1.896, P=0.423) and cases of death (OR=0.929, 95%CI: 0.567-1.515, P=0.767). The 12-month secondary patency rate (HR=1.427, 95% CI: 1.048-1.944,P=0.024) and the 18-month secondary patency rate (HR=1.531, 95% CI: 1.128-2.079, P=0.006) were higher in standard PTFE grafts than in early cannulation grafts, with statistically significant differences. PTFE grafts had a higher risk of pseudoaneurysm formation (OR=0.361, 95% CI: 0.138 - 0.943, P=0.038) than early cannulation grafts, with statistically significant differences as well.
ConclusionAlthough early cannulation grafts had a lower incidence of pseudoaneurysm formation than standard PTFE grafts in terms of the risk of complications, there was no significant statistic difference of the patency rate for the two ways of treatment during 24 months of their use. Therefore, both of the two options of treatment are feasible and practical.
Key words:
Early cannulation grafts; Standard polytetrafluoroethylene grafts; Hemodialysis access; Arteriovenous grafts
Contributor Information
Zheng Lei
China-Japan Friendship Clinical Medical College of Peking University, Beijing 100083, China
Zhao Hao
China-Japan Friendship Clinical Medical College of Peking University, Beijing 100083, China
Ma Bo
Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing 100029, China
Chen Jie
Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing 100029, China
Zhang Jianbin
Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing 100029, China
Ye Zhidong
Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing 100029, China
