Preexisting intimal hyperplasia of radial artery is associated with early failure of radiocephalic arteriovenous fistula in hemodialysis patients

Kim, Young Ok; Song, Ho Cheol; Yoon, Sun Ae; Yang, Chul Woo; Kim, Namil; Choi, Yeong Jin; Lee, Eun Jung; Kim, Wan Young; Chang, Yoon Sik; Bang, Byung Kee

doi:10.1053/ajkd.2003.50051

Cited by 84 publications

(77 citation statements)

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“…Although it is unlikely that postoperative IH alone leads to critical AVF occlusion (10), it may be a contributing factor to AVF nonmaturation in the setting of inadequate outward remodeling. More recently, IH has been also identified as a common preexisting (13,14). These studies emphasized the profound histologic differences between preexisting and postoperative IH ( Figure 1).…”

Section: Ih Pathobiology Of Preexisting Ihmentioning

confidence: 93%

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New Insights into Dialysis Vascular Access: Impact of Preexisting Arterial and Venous Pathology on AVF and AVG Outcomes

Vázquez-Padrón

Allon

2016

CJASN

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Despite significant improvements in preoperative patient evaluation and surgical planning, vascular access failure in patients on hemodialysis remains a frequent and often unforeseeable complication. Our inability to prevent this complication is, in part, because of an incomplete understanding of how preexisting venous and arterial conditions influence the function of newly created arteriovenous fistulas and grafts. This article reviews the relationship between three preexisting vascular pathologies associated with CKD (intimal hyperplasia, vascular calcification, and medial fibrosis) and hemodialysis access outcomes. The published literature indicates that the pathogenesis of vascular access failure is multifactorial and not determined by any of these pathologies individually. Keeping this observation in mind should help focus our research on the true causes responsible for vascular access failure and the much needed therapies to prevent it.

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Section: Ih Pathobiology Of Preexisting Ihmentioning

confidence: 93%

“…Two pilot studies reported a positive association between preexisting arterial or venous IH and AVF maturation failure (13,14). Kim et al (14) observed preexisting arterial IH in 45 of 59 (76%) patients undergoing AVF creation.…”

Section: Ih and Avf Outcomesmentioning

confidence: 99%

New Insights into Dialysis Vascular Access: Impact of Preexisting Arterial and Venous Pathology on AVF and AVG Outcomes

Vázquez-Padrón

Allon

2016

CJASN

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“…Pre-existing arterial neointimal hyperplasia has been described by Kim et al to be present in most radial arteries used to create new AVFs and to be associated with AVF maturation failure (22). Arterial microcalcification has also been reported to be present in the majority of radial arteries used to create new AVFs and present predominately within the media layer (23).…”

Section: Histopathology Of Uremic Vessels Prior To Vascular Access Crmentioning

confidence: 99%

Novel Paradigms for Dialysis Vascular Access

Lee

2013

Clinical Journal of the American Society of Nephrology

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SummaryVascular access dysfunction is a major cause of morbidity and mortality in hemodialysis patients. The most common cause of vascular access dysfunction is venous stenosis from neointimal hyperplasia within the perianastomotic region of an arteriovenous fistula and at the graft-vein anastomosis of an arteriovenous graft. There have been few, if any, effective treatments for vascular access dysfunction because of the limited understanding of the pathophysiology of venous neointimal hyperplasia formation. This review will (1) describe the histopathologic features of hemodialysis access stenosis; (2) discuss novel concepts in the pathogenesis of neointimal hyperplasia development, focusing on downstream vascular biology; (3) highlight future novel therapies for treating downstream biology; and (4) discuss future research areas to improve our understanding of downstream biology and neointimal hyperplasia development.

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“…A plausible hypothesis is that preexisting vascular pathology predisposes to accelerated neointimal hyperplasia and juxtaanastomotic stenosis in patients receiving a new AVF. A pilot Korean study reported significantly decreased AVF patency in patients with preexisting arterial intimal hyperplasia compared with that observed in patients without this pathology (23). A second study found no association of preexisting arterial medial fibrosis or arterial calcification with AVF nonmaturation (18).…”

mentioning

confidence: 96%

“…Several arterial and venous abnormalities have been described in patients undergoing vascular access creation, including venous intimal hyperplasia, arterial intimal hyperplasia, arterial medial fibrosis, arterial calcification, and venous calcification (18,(20)(21)(22)(23). A plausible hypothesis is that preexisting vascular pathology predisposes to accelerated neointimal hyperplasia and juxtaanastomotic stenosis in patients receiving a new AVF.…”

mentioning

confidence: 99%

Novel Paradigms for Dialysis Vascular Access

Allon

2013

Clinical Journal of the American Society of Nephrology

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Preexisting intimal hyperplasia of radial artery is associated with early failure of radiocephalic arteriovenous fistula in hemodialysis patients

Cited by 84 publications

References 0 publications

New Insights into Dialysis Vascular Access: Impact of Preexisting Arterial and Venous Pathology on AVF and AVG Outcomes

New Insights into Dialysis Vascular Access: Impact of Preexisting Arterial and Venous Pathology on AVF and AVG Outcomes

Novel Paradigms for Dialysis Vascular Access

Novel Paradigms for Dialysis Vascular Access

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