Predicting loss of patency after forearm loop arteriovenous graft

Suemitsu, Kotaro; Iida, Osamu; Shiraki, Tatsuya; Suemitsu, Satoko; Murakami, Masaaki; Miyamoto, Masahito; Izumi, Masayuki; Nakanishi, Takeshi

doi:10.1016/j.jvs.2016.02.049

Cited by 12 publications

(6 citation statements)

References 18 publications

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“…Sensitivity analysis of the patency rates after primary and secondary operations, and at the end of the study, corroborated the superiority of pRBAVF; the primary patency rate was ≥5% higher that of BBVAF, while the secondary and overall patency rates were similar between the methods. These results are in line with the results of the study by Suemitsu et al [28] that indicates the selection of the radial artery contributes to the higher primary patency rate. Rosas et al [29] reported that AVF was useful when the maturation rate was ≥69%, and evaluated the costeffectiveness of initial AVF and synthetic vascular access in hemodialysis patients.…”

Section: Discussionsupporting

confidence: 92%

Cost‐effectiveness analysis of radiobasilic and brachiobasilic arteriovenous fistulas in hemodialysis patients

2021

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We evaluated the cost and efficacy of radiobasilic and brachiobasilic arteriovenous fistula (AVF) methods in terms of forearm autogenous arteriovenous access in hemodialysis patients. We used a decision tree to compare the cost-effectiveness of proximal radiobasilic AVF (pRBAVF) and brachiobasilic AVF (BBAVF), considering the mean direct medical costs and patency rates. The overall mean cost of pRBAVF per patient (1767.59 Turkish lira [TL]) was lower than that of BBAVF (1877.99 TL). Also, the mean patency duration per patient was higher for pRBAVF (25.72 months) than BBAVF (20.21 months). The incremental cost-effectiveness ratio (ICER) showed that pRBAVF was 20.04-fold more effective than BBAVF. The monthly ICERs also favored pRBAVF, which was less costly and more effective. The pRBAVF provided clinical and economic benefits for hemodialysis patients requiring forearm autogenous arteriovenous access. pRBAVF was more effective in terms of patency than BBAVF, and was also less expensive.

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Section: Discussionsupporting

confidence: 92%

Cost‐effectiveness analysis of radiobasilic and brachiobasilic arteriovenous fistulas in hemodialysis patients

2021

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“…To our knowledge, there is no existing meta-analysis regarding AVG patency rates. One recent study 6 from a multicenter cohort in Japan showed a one-year primary patency rate of 25% and a one-year secondary patency rate of 85%. Our cohort showed slightly better primary patency outcomes and similar secondary patency outcomes.…”

Section: Discussionmentioning

confidence: 99%

Arteriovenous graft patency outcomes and prognostic factors

et al. 2018

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Objectives Arteriovenous graft for hemodialysis shows poorer outcomes than arteriovenous fistula, due to frequent stenosis and thrombosis. We investigated arteriovenous graft patency outcomes and prognostic factors for these outcomes. Methods We included a single-center cohort of patients receiving arteriovenous graft for hemodialysis access from 2010 to 2014. Demographics, laboratory data, comorbidities, and medications were collected from medical records. Surgical factors related to graft operation including the type and diameter of connected vessels, graft location, and type of operation (elective or emergency) were also recorded. Outcomes included primary and secondary patency. Survival analysis was conducted using the Kaplan-Meier method; univariate and multivariate analyses were used to evaluate the prognostic factors. Results Data from 225 grafts were analyzed. During the follow-up period (mean: 583 days, range: 1–1717 days), 138 (61%) grafts required intervention and 46 (20%) permanently failed. Primary patency at one, two, and three years was 42%, 20%, and 16%, respectively. Secondary patency at one, two, and three years was 85%, 72%, and 64%, respectively. Multivariate analysis showed that primary patency was negatively associated with increasing age and location of vessel anastomosis (reference-brachiobrachial anastomosis; brachiobasilic – HR, 0.569; 95% CI, 0.376–0.860; p = 0.007; brachioaxillary anastomosis – HR 0.407; 95% CI, 0.263–0.631; p < 0.0001); secondary patency was positively associated with diastolic blood pressure, serum albumin level, and hemoglobin over 10 g/dL. Adverse events other than stenosis or thrombosis, such as infection/inflammation or pseudoaneurysm were observed in approximately 20% of grafts. Conclusions Factors associated with diminished primary arteriovenous graft patency included increased patient age and location of vessel anastomosis (brachiobrachial type compared to brachiobasilic or brachioaxillary type); diminished secondary patency was associated with low diastolic blood pressure, low serum albumin, and hemoglobin level under 10 g/dL. Among these factors, diastolic blood pressure, serum albumin, and hemoglobin level may be modifiable and could improve arteriovenous graft patency outcomes.

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“…The primary patency rate was significantly different between the radial artery and brachial artery inflow at one year (53.8% versus 24.4%, P=0.032). 10) Our study showed a different result: in all cases, the inflow artery chosen in our study was the brachial artery with a size larger than 2 mm. Moreover, the primary patency was 58.82% at one year.…”

Section: Discussionmentioning

confidence: 72%

The Effect of Artery and Vein Size on Forearm Hemodialysis Arteriovenous Graft Patency

Kritayakirana

Narueponjirakul

Uthaipaisanwong

et al. 2019

Annals of Vascular Diseases

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Objective: Arteriovenous grafts (AVGs) are considered to be an alternative procedure when autogenous fistulas are not feasible. This study was conducted to establish a correlation between the inflow artery and outflow vein size and patency of AVGs.Materials and Methods: This was a retrospective descriptive study. Data was collected from patients who had forearm AVG performed at a university hospital from January 1, 2012, to December 31, 2016. Spearman’s rho correlation test was used to identify the correlation between the artery and vein size and patency of AVG.Results: A total of 34 patients were enrolled in this study. Forearm loop configuration was performed in 33 patients (97%), and straight configuration was performed in one patient (3%). The median size of the brachial artery was 3 mm (interquartile range [IQR]: 2, 4) and that of the vein was 3 mm (IQR: 2, 5). The overall primary patency was 74% at six months, 59% at one year, and 32% at two years. The analysis showed that the primary patency increased with the artery size, but there was a reverse correlation between vein sizes.Conclusion: Small inflow arteries may reduce the primary patency, but small veins do not result in a poor primary patency. Our method can be applied to patients with small veins, where it is still possible to perform forearm AVGs.

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Predicting loss of patency after forearm loop arteriovenous graft

Abstract: Radial artery selection as inflow artery was independently associated with primary patency after AVG.

Cited by 12 publications

References 18 publications

Cost‐effectiveness analysis of radiobasilic and brachiobasilic arteriovenous fistulas in hemodialysis patients

Cost‐effectiveness analysis of radiobasilic and brachiobasilic arteriovenous fistulas in hemodialysis patients

Arteriovenous graft patency outcomes and prognostic factors

The Effect of Artery and Vein Size on Forearm Hemodialysis Arteriovenous Graft Patency

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