Arteriovenous fistula for haemodialysis: The role of surgical experience and vascular access education

Fila, Branko; Ibeas, José; Roca-Tey, Ramón; Lovčić, Vesna; Zibar, Lada

doi:10.1016/j.nefro.2015.07.003

Cited by 21 publications

(15 citation statements)

References 69 publications

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“…An increase in the global incidence of end-stage renal disease (ESRD) has led to the increasing demand for hemodialysis. 1,2) The success of dialysis depends on the creation and maintenance of adequate vascular access for chronic use. Although a native arteriovenous fistula (AVF) is recommended by guidelines as the primary choice for long-term hemodialysis access with a steady increase of its use in many countries, [3][4][5] the ongoing challenge facing vascular surgeons is the difficulty in forecasting the types of AVFs that will successfully mature and have long-term survival.…”

Section: Introductionmentioning

confidence: 99%

Survival and Prognostic Predictors of Primary Arteriovenous Fistula for Hemodialysis

Wongmahisorn

2019

Annals of Vascular Diseases

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Objectives: This study aims to evaluate the survival and prognostic predictors of arteriovenous fistulas (AVFs) among patients undergoing AVF creation. The significant predictors were incorporated into a prognostic model to determine its prognostic performance for five-year AVF survival. Materials and Methods: Data on 290 patients who underwent first-time AVF creation and who had been followed up for at least 5 years or until AVF failure were reviewed. The Kaplan-Meier survival curves and Cox proportional hazards model were generated to determine the AVF survival and associated prognostic predictors. Significant predictors were used to derive a prognostic model. Results: The mean age of the patients was 59.7±14.6 years, and the 5-year AVF survival rate was 34.5%. Three features were found to be independent prognostic factors for the five-year AVF survival: old age, diabetes mellitus, and prior central venous catheter placement. These three significant factors were integrated into a prognostic scoring model that ranged from zero to five points. According to this model, the patients whose scores were 0, 1, 2, 3 and 4 or more had five-year AVF survival rates of 60.0%, 45.3%, 36.6%, 15.0%, and 2.9%, respectively. Conclusion: The five-year survival rate of AVFs was modest, and a prognostic model could excellently estimate the fiveyear AVF survival.

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Section: Introductionmentioning

confidence: 99%

Survival and Prognostic Predictors of Primary Arteriovenous Fistula for Hemodialysis

Wongmahisorn

2019

Annals of Vascular Diseases

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“…Generally, this is the way a vascular access, called an arteriovenous fistula (AVF), is created and done by a surgical operation in which arteries and veins are connected together. As mentioned in another study [ 2 , 3 ], AVF provides the lowest risk of death caused by inadequate vascular access, low complication rate, long term use, and lower cost compared to other (arteriovenous graft and central venous catheter) vascular access options. Ready to use (mature) AVF are characterized by the formation of venous distension and arterialization after 6–12 weeks.…”

Section: Introductionmentioning

confidence: 99%

A Novel Classification Technique of Arteriovenous Fistula Stenosis Evaluation Using Bilateral PPG Analysis

Stephanus

2016

Micromachines

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The most common treatment for end-stage renal disease (ESRD) patients is the hemodialysis (HD). For this kind of treatment, the functional vascular access that called arteriovenous fistula (AVF) is done by surgery to connect the vein and artery. Stenosis is considered the major cause of dysfunction of AVF. In this study, a noninvasive approach based on asynchronous analysis of bilateral photoplethysmography (PPG) with error correcting output coding support vector machine one versus rest (ESVM-OVR) for the degree of stenosis (DOS) evaluation is proposed. An artificial neural network (ANN) classifier is also applied to compare the performance with the proposed system. The testing data has been collected from 22 patients at the right and left thumb of the hand. The experimental results indicated that the proposed system could provide positive predictive value (PPV) reaching 91.67% and had higher noise tolerance. The system has the potential for providing diagnostic assistance in a wearable device for evaluation of AVF stenosis.

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“…However, the skill and experience of the surgeon is an important parameter that influences the success of the intervention. The risk of primary thrombosis of the arteriovenous fistula was 34% lower if it had been created by surgeons who had already created at least 25 fistulas previously [6]. The DOPPS study confirmed that in Australia, New Zealand, Germany, and Japan, 50-72% of patients with end-stage kidney diseases initiated hemodialysis with an arteriovenous fistula compared with 16% in the USA [5,[21][22][23][24] this study also had many years of experience, with several dozen fistulas done individually.…”

Section: Discussionmentioning

confidence: 99%

“…This should be performed by a vascular surgeon, but the procedure is also carried out by other specialists (urologists, general, and cardiovascular surgeons). Unfortunately, many studies have confirmed insufficient support from surgical services, which is why nephrologists in many centers began to create arteriovenous fistulas themselves [6].…”

Section: Introductionmentioning

confidence: 99%

Are There Differences in Arteriovenous Fistulae Created for Hemodialysis between Nephrologists and Vascular Surgeons?

et al. 2020

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Objective: Arteriovenous fistulae can be a reason for frustration among nephrologists dependent on surgeons. This is why nephrologists in many centers have begun to create arteriovenous fistulas themselves. The aim of this study was to determine possible differences and predictive parameters for arteriovenous fistula function in patients whose fistulas were created by a nephrologist or a vascular surgeon. Methods. The study was organized as a retrospective, descriptive-analytical study of interventions by nephrologists and vascular surgeons during a period of 15 years. The total number of arteriovenous fistulae created by surgical interventions in this interval was 1048. A nephrologist created them in 764 (72.9%) patients, while vascular surgeons were responsible for 284 (27.1%) fistulae. All laboratory, demographic, and clinical parameters which might affect functioning of these arteriovenous fistulae were analyzed. Results. Patients whose arteriovenous fistula was formed by the nephrologist differed significantly from those created by vascular surgeons in relation to positioning of the anastomosis (p <0.001), the preventive character of the arteriovenous fistula (p <0.001), lumen of the vein (p = 0.004) and systolic blood pressure (p = 0.02). Statistically significant predictors of arteriovenous fistula dysfunction, in the multivariate logistic regression model, were female gender (B = 0.439; p = 0.003), who created the fistula (vascular surgeon or nephrologist) (B = 0.325; p = 0.041), and the site of the arteriovenous fistula (B = -0.454; p = 0.002). Conclusion. Arteriovenous fistulae created by vascular surgeons, female gender and the location are predictors of dysfunction.

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Arteriovenous fistula for haemodialysis: The role of surgical experience and vascular access education

Cited by 21 publications

References 69 publications

Survival and Prognostic Predictors of Primary Arteriovenous Fistula for Hemodialysis

Survival and Prognostic Predictors of Primary Arteriovenous Fistula for Hemodialysis

A Novel Classification Technique of Arteriovenous Fistula Stenosis Evaluation Using Bilateral PPG Analysis

Are There Differences in Arteriovenous Fistulae Created for Hemodialysis between Nephrologists and Vascular Surgeons?

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