关键词: No?touch技术, 动静脉内瘘, 缺氧, 内膜增生, 近吻合口静脉, 静脉分离

Abstract:  The damage to vasa vasorum caused by dissection of juxta-anastomotic veins during autologous arteriovenous fistula (AVF) surgery and the changes of hemodynamics after AVF construction can lead to early postoperative hypoxia of the juxta-anastomotic venous wall. As a result, hypoxia inducible factors (HIFs) and its downstream signal pathway are activated to induce cell proliferation and collagen deposition in juxta-anastomotic venous wall, and intimal hyperplasia and stenosis are thus produced. During coronary artery bypass surgery, the no-touch technique used for great saphenous vein dissection can reduce the damage to venous vasa vasorum in the venous dissection operation, and the preserved perivenous tissue has external supporting effects to reduce the hemodynamic changes of the vein graft. Therefore, the no-touch technique can alleviate hypoxia and intimal hyperplasia of the vein graft. In recent years, this technology has been applied to vein dissection during AVF surgery, and achieved better clinical results. In this review, we summarize the mechanism and research advances in the use of no touch technique to dissect veins during surgery to alleviate early postoperative juxta-anastomotic venous hypoxia and intimal hyperplasia of the arteriovenous fistula.

Key words: No touch technique, Arteriovenous fistula, Hypoxia, Intimal hyperplasia, Juxta-anastomotic vein, Venous dissection