Association of Preoperative Mean Arterial Pressure With the Primary Failure of Brescia‐Cimino Arteriovenous Fistula Within the First 7 Days Following Surgery in Hemodialysis Patients

Yan, Yan; Su, Xiaoxia; Zheng, Jie; Zhang, Li; Liu, Yang; Jiang, Qing; Chen, Qinkai

doi:10.1111/1744-9987.12670

Cited by 2 publications

(3 citation statements)

References 21 publications

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“…21 Yan et al found that preoperative low preoperative mean arterial pressure is a risk factor for primary failure within postoperative seven days. 22 Similarly, Eslami et al also showed that hypertension is one of the protective factors of early failure. 23 Our result suggests that hypertension might be a protective factor for recurrent thrombosis, leading to subsequent maturation.…”

Section: Discussionmentioning

confidence: 94%

Outcome after early thrombotic occlusion of arteriovenous fistulas

Ahn

Han

et al. 2022

J Vasc Access

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Objective: Arteriovenous fistulas (AVFs) are considered the first choice for venous access in end-stage renal disease patients, however, they are also known to have a high primary failure rate (early thrombosis and maturation failure). Of these, the outcome of thrombosed immature AVFs is not well known. This study aimed to investigate the outcome of AVFs with early thrombosis. Methods: Patients who underwent AVF creation from January 2009 to December 2019 at Seoul National University Hospital or Seoul Metropolitan Government – Seoul National University Boramae Medical Center were retrospectively reviewed. Patients who received salvage operations due to early thrombosis within 30 days after access creation were analyzed. Results: During the study period, a total of 45 patients (radiocephalic 26; brachiocephalic 19) developed early thrombosis and underwent salvage operations. The median age of patients was 61.0 (54.5–69.5) years, and 51.1% were male. The first salvage operation was performed on the median 1.0 (0.0–4.5) day after AVF creation. The most common cause for early thrombosis was venous stenosis (64.4%) and followed by poor arterial inflow (28.9%), especially in radiocephalic AVFs. About 20 AVFs were salvaged to maturation (46.5%). Post-salvage primary patency and secondary patency at 1 year was 72.6% and 100%. In a multivariate logistic regression, significant risk factors for maturation failures were minimum venous outflow diameter ⩽2.5 mm (OR, 4.433; 95% CI, 1.039–18.921; p = 0.044) and lower in patients with hypertension (OR, 0.064; 95% CI, 0.006–0.637; p = 0.019). Conclusions: Thrombosed immature AVFs are associated with a high failure rate after salvage operation. However, if the salvage operation is successfully performed, it is associated with an acceptable 1-year outcome.

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Section: Discussionmentioning

confidence: 94%

Outcome after early thrombotic occlusion of arteriovenous fistulas

Ahn

Han

et al. 2022

J Vasc Access

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“…Pandey et al studied 224 patients prospectively and reported that patients with early AVF failure had lower diastolic blood pressure of 88.4 mmHg compared to 91.2mmHg in those with AVF success 39 . Similarly, a retrospective review of 1051 patients found patients with early primary failure had lower diastolic pressure of 79.7mmHg compared to 83.1mmHg in those with AVF success 38 . In the present study, lower diastolic blood pressure and mean arterial pressure pre-surgery were associated with an increased risk of AVF failure with an AVF failure exceeding 50% at a diastolic blood pressure of 80 mmHg or lower.…”

Section: Discussionmentioning

confidence: 97%

“…Earlier studies suggested that tight control of systolic, diastolic and/or mean arterial pressures pre-operatively was associated with increased odds of AVF thrombosis 36,37 and early primary AVF failure 38,39 . Pandey et al studied 224 patients prospectively and reported that patients with early AVF failure had lower diastolic blood pressure of 88.4 mmHg compared to 91.2mmHg in those with AVF success 39 .…”

Section: Discussionmentioning

confidence: 99%

Predictors of Arteriovenous Fistula Failure: A Post Hoc Analysis of the FAVOURED Study

et al. 2020

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Background An autologous arteriovenous fistula (AVF) is the preferred hemodialysis vascular access but successful creation is hampered by high rates of AVF failure. This study aimed to evaluate patient and surgical factors associated with AVF failure to improve vascular access selection and outcomes. Methods This is a post-hoc analysis of all participants of FAVOURED, a multi-center, double-blind, multinational, randomized placebo-controlled trial evaluating the effect of fish oil and/or aspirin in preventing AVF failure in patients receiving hemodialysis. The primary outcome of AVF failure was a composite of fistula thrombosis and/or abandonment and/or cannulation failure at 12 months post AVF creation and secondary outcomes included individual outcome components. Patient data (demographics, comorbidities, medications and laboratory data) and surgical factors (surgical expertise, anesthetic, intraoperative heparin use) were examined using multivariable logistic regression analyzes to evaluate associations with AVF failure. Results Of 536 participants, 253 patients (47%) experienced AVF failure during the study period. The mean age was 55 ± 14.4 years, 64% were male, 45% were diabetic and 4% had peripheral vascular disease. Factors associated with AVF failure included female sex (odds ratio [OR] 1.79, 95% confidence interval [CI] 1.20-2.68), lower diastolic blood pressure (OR for higher DBP 0.85, 95% CI 0.74-0.99), presence of central venous catheter (OR 1.49, 95% CI 1.02-2.20, p=0.04) and aspirin requirement (OR 1.60, 95% CI 1.00-2.56). Conclusions 3 Female sex, requirement for aspirin therapy, requiring hemodialysis via a central venous catheter and lower diastolic blood pressure were factors associated with higher odds of AVF failure. These associations have potential implications for vascular access planning and warrant further studies.

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Association of Preoperative Mean Arterial Pressure With the Primary Failure of Brescia‐Cimino Arteriovenous Fistula Within the First 7 Days Following Surgery in Hemodialysis Patients

Cited by 2 publications

References 21 publications

Outcome after early thrombotic occlusion of arteriovenous fistulas

Outcome after early thrombotic occlusion of arteriovenous fistulas

Predictors of Arteriovenous Fistula Failure: A Post Hoc Analysis of the FAVOURED Study

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