TITLE: Novel Approaches to Arteriovenous Access Creation, Maturation, Suitability, and Durability for Dialysis.

ABSTRACT: Since the arteriovenous fistula (AVF) was first conceived over 50 years ago, the goal to create a vascular conduit with predictable and reproducible maturation and durability continues to elude caregivers. Recently, however, advances in the understanding of vascular biology and new technologies now provides us with some optimism; we are moving toward a viable solution. A quickly maturing, sustainable, and durable arteriovenous access may soon be attainable. This review will discuss these advances. There are novel approaches to AVF creation and devices to enhance maturation, advances in arteriovenous graft material(s), and devices to safely prolong the use of tunneled dialysis catheters. Although hemodialysis (HD) access remains a complex problem, these innovations may lead the way to optimizing the care and the quality of life of those patients who have no choice but to proceed with HD.

SOURCE: DeVita MV, Khine SK, Shivarov H. Novel Approaches to Arteriovenous Access Creation, Maturation, Suitability, and Durability for Dialysis[J]. Kidney Int Rep, 2020, 5(6):769-778. DOI: 10.1016/j.ekir.2020.02.1024. 

摘要： 自动静脉内瘘（AVF）于50年前首次提出以来，创建具有可预测和可再现，成熟和持久的血管导管的目标仍然是照顾者所不能实现的。但是，近来，对血管，生物学和新技术的了解的进步使我们有些乐观。我们正在朝着可行的解决方案迈进。快速成熟，可持续和持久的动静脉通路可能很快就会实现。这篇综述将讨论这些进展。存在用于AVF产生的新方法和促成熟的装置，动静脉移植物，材料和装置的安全发展以安全地延长隧道透析导管的使用。尽管血液透析（HD）通路仍然是一个复杂的问题，但是这些创新可能会为那些没有选择而不得不继续进行HD的患者提供优化，护理和生活质量的方法。

启发：打开思路，尝试新方法，解决老问题，通路人任重道远！