Our data suggest that maturation of AVFs using objective criteria based on DDUS provides an opportunity to identify NAS problems in outflow veins before cannulation. Most of the of the AVF outflow veins (71.7%) could be transposed or superficialized using MIST, with excellent long-term outcomes.
were maturation and, for those that matured, time of functioning access, defined as the time from the first use to the irreparable failure of the access. Secondary outcomes were time to maturation, complications, and time to first complication.Results: Study group patients were 3.8-times more likely to have a fistula mature compared to the controls (88% vs 66%; RR, 3.8; 95% CI, 1.3-11.6; P ¼ .016). Fewer patients in the study group had complications (76% vs 92%; P ¼ .025), and the time from the construction of the fistula to the first complication was longer (345.6 6 441 days vs 198.3 6 185.0 days; P ¼ .025). Time to maturation for those fistulas that matured was similar in both groups (119.3 6 62.9 days vs 100.2 6 61.7 days; P ¼ .2). However, once matured, the time to failure was significantly longer in the treatment group (903.7 6 543.6 days vs 381.6 6 317.2 days; P ¼ .001). Multivariate analysis confirmed that the likelihood of maturation is significantly higher in treatment group patients.Conclusions: These results suggest that patients undergoing dialysis access may benefit from preoperative and postoperative cilostazol therapy. If this hypothesis is confirmed by a randomized trial, this treatment will have a major beneficial impact on the growing a number of patients dependent on a well-functioning access for their hemodialysis.
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