Careful Patient Selection Achieves High Radiocephalic Arteriovenous Fistula Patency in Diabetic and Female Patients

Okamuro, Luke; Gray, Kelsey; Korn, Abraham; Parrish, Aaron B.; Kaji, Amy H.; Howell, Erin; Bowens, Nina; Virgilio, Christian de

doi:10.1016/j.avsg.2018.12.057

Cited by 14 publications

(11 citation statements)

References 22 publications

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“…This was attributed to the smaller vessel dimensions in women 10 . However, two other studies showed no gender discrepancy, as was our observation 13,14 …”

Section: Discussionsupporting

confidence: 78%

“…10 However, two other studies showed no gender discrepancy, as was our observation. 13,14 It is well known that routine preoperative doppler screening that identifies the optimal blood vessel for AVF creation had better outcomes. 15 Limitations of this study are the lack of intradialytic arterial pressure data, failure to include patients who had undergone multiple repeat AVF surgeries after failure and erythropoietin dose and usage.…”

Section: Discussionmentioning

confidence: 99%

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A multicentre analysis of the outcome of arteriovenous fistula in maintenance haemodialysis

Jothi

Kg²,

Lesley

et al. 2020

Seminars in Dialysis

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Introduction: Arteriovenous fistulas (AVF) are the preferred choice for vascular access in hemodialysis. We aim to identify factors that may contribute to AVF failure. Methods: Data regarding AVF survival were collected from 441 patients. All AVFs were either radial or brachial, of the end‐to‐side variety. Parameters studied were age, gender, diabetes mellitus, hypertension prior to end‐stage kidney disease (ESKD), site of fistula, blood flow rate, venous pressure, dialysis vintage and frequency, needle gauge used during dialysis, year of fistula creation, and details of fistula failure. Findings: The 6‐month, 1‐year and 2‐year AVF survival rates were 98.41%, 95.01%, and 89.57%. Failure rates were 17.2%, 5.5%, 26.8%, and 14.4% for dominant radial, non‐dominant radial, dominant brachial and non‐dominant brachial respectively (P < 0.001). Using a larger needle size had better AVF survival rate (P < 0.05). All other factors had no significant correlation with AVF failure. Conclusion: There were no statistically significant differences in AVF patency with respect to gender, age, blood flow rate, presence of diabetes mellitus or systemic hypertension. A distally placed AVF in the nondominant arm had the best survival rate. Using a larger needle size, specifically 15G during dialysis, was associated with lowest AVF failure.

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“…This was attributed to the smaller vessel dimensions in women 10 . However, two other studies showed no gender discrepancy, as was our observation 13,14 …”

Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

A multicentre analysis of the outcome of arteriovenous fistula in maintenance haemodialysis

Jothi

Kg²,

Lesley

et al. 2020

Seminars in Dialysis

View full text Add to dashboard Cite

show abstract

“…13 Indeed, a meta-analysis by Yan et al 20 revealed a significantly higher rate of AVF failure in diabetic patients compared with nondiabetic patients. Conversely, Okamuro et al 21 reported that DM was not significantly associated with increased radiocephalic AVF failure. Consistent with this report, we failed to find a relationship between DM and the AVF patency rate.…”

Section: Discussionmentioning

confidence: 95%

Predictive Value of 1-Week Postoperative Ultrasonography Findings for the Patency Rate of Arteriovenous Fistula

Shimizu

Nakata

Maiguma

et al. 2020

Kidney International Reports

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Introduction: Most guidelines in different countries recommend waiting more than 2 weeks for the initial cannulation of an arteriovenous fistula (AVF) after its creation. Although an experienced examiner can subjectively determine if an AVF is ready for early cannulation, there is a lack of objective information to guide whether early cannulation is appropriate or how early cannulation may affect an AVF's primary patency. The current study examined the relationship between the initial cannulation and the prognosis of AVF, considering ultrasonography (US) findings. Methods: This retrospective observational study enrolled 103 patients with end-stage renal disease who had started hemodialysis therapy from 2013 to 2015 at the Juntendo University Hospital. All patients had been given a primary AVF before or after the initiation of dialysis, had undergone US examinations both before and 7 days after surgery, had initially cannulated the AVF at $7 days after surgery, and were observed for over 1 year. Results: The factor associated with the loss of primary patency was a resistance index of brachial artery $0.65 on US examination at 7 days after surgery. There was no significant difference in patency rate between the early (within 14 days after surgery) and late initial cannulation groups ($15 days after surgery). Conclusion: Because a resistance index <0.65 on US findings at 7 days after surgery was a good indicator for predicting an excellent patency rate when we performed first cannulation of AVF located in the forearm within 2 weeks after its creation, 1-week postoperative US evaluation may provide crucial information.

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“…A number of studies have focused on factors that predict a successful i.e. functional AVF [15], [16], [17], [18]. Bashar at al., 2015 reported 52 functionally matured fistula from a total of 97 fistulae (53.60%).…”

Section: Discussionmentioning

confidence: 99%

Primary Failure of the Arteriovenous Fistula in Patients with Chronic Kidney Disease Stage 4/5

Gjorgjievski

Dzekova‐Vidimliski

Gerasimovska

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: An Arteriovenous fistula (AVF) is a creation of the natural blood vessels. It is a “gate of life” for the patients on hemodialysis. AIM: The study aimed to analyze the predictors for primary failure of AVF such as gender, age, number and location of AVF, and primary renal disease in patients with chronic kidney disease (CKD) stage 4/5.MATERIAL AND METHODS: The medical records of 178 created arteriovenous fistulae in patients with CKD stage 4/5, were retrospectively studied. Primary failure of AVF was defined as thrombosis or inability for cannulation of AVF within 3 months. Adequate maturation of AVF was defined as successful cannulation of AVF treatment and blood flow of > 600 ml/min.RESULTS: The mean age of the patients was 59.75 ± 14.65 years, and 65.16% (116/178) were men. Adequate maturation of AVF was achieved in 83.71% (149/178). Primary failure of AVF occurred in 16.29% (29/178) of the created fistulae, while 10.11% (18/178) had early thrombosis. The distal arteriovenous fistulae were significantly more frequently created in male patients (51 vs 18; p = 0.015). The female patients were significantly older than the male patients (63.27 vs 57.86 years; p = 0.018). CONCLUSION: Male gender was associated with better maturation of AVF. The age, number and location of AVF, and primary renal disease in patients with CKD stage 4/5 were not associated with primary failure of AVF.

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Careful Patient Selection Achieves High Radiocephalic Arteriovenous Fistula Patency in Diabetic and Female Patients

Cited by 14 publications

References 22 publications

A multicentre analysis of the outcome of arteriovenous fistula in maintenance haemodialysis

A multicentre analysis of the outcome of arteriovenous fistula in maintenance haemodialysis

Predictive Value of 1-Week Postoperative Ultrasonography Findings for the Patency Rate of Arteriovenous Fistula

Primary Failure of the Arteriovenous Fistula in Patients with Chronic Kidney Disease Stage 4/5

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