Radiocephalic Wrist Arteriovenous Fistula for Hemodialysis: Meta-analysis Indicates a High Primary Failure Rate

Rooijens, P.P.G.M.; Tordoir, Jan H.M.; Stijnen, T.; Burgmans, J. P. J.; De, Apitzsch; Yo, T.I.

doi:10.1016/j.ejvs.2004.08.014

Cited by 278 publications

(232 citation statements)

References 33 publications

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“…9 The immediate failure rate in our study is 9.09% (n=3) which varies from 10-30% in various studies. 9,14,15 The failure rate in our series is 9.09% (n=3) at 6 months follow up which is lower than that reported from a study in Nigeria with 35.1% failure rate at 1 year.…”

contrasting

confidence: 53%

Clinical profile and early outcome of arteriovenous fistula creation for haemodialysis: Integrated activity in a general surgery unit

Lamichhane

Paudyal

Maskey

et al. 2017

J. Soc. Surg. Nepal

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contrasting

confidence: 53%

Clinical profile and early outcome of arteriovenous fistula creation for haemodialysis: Integrated activity in a general surgery unit

Lamichhane

Paudyal

Maskey

et al. 2017

J. Soc. Surg. Nepal

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“…A significant proportion of the AVFs encounter PF during the first weeks after surgery (6,11,15); however, when patency rates are calculated starting at the day of first cannulation, primary failed AVFs are not included. To prevent confusion and incorrect comparisons, we discriminated patency from functional patency as reported by Sidawy et al (14).…”

Section: Patency Ratesmentioning

confidence: 99%

Hemodialysis Arteriovenous Fistula Patency Revisited

Huijbregts

Bots²,

Wittens³

et al. 2008

Clinical Journal of the American Society of Nephrology

322

239

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Background and objectives: Vascular access standards are predominantly based on older, single-center reports; however, the hemodialysis population has changed dramatically and primary arteriovenous fistula failure is a huge problem. This prospective, multicenter study used standardized definitions to analyze patency rates and potential risk factors that affect functional patency and late arteriovenous fistula functionality.Design, setting, participants, & measurements: Eleven centers participated in a guidelines implementation program. All new permanent vascular accesses were included. Patency and functional patency, defined as access survival from creation and from first dialysis use, respectively, were calculated using Kaplan-Meier analysis. Risk factors for primary functional patency loss (intervention-free interval) and secondary failure (abandonment) were determined using regression models.Results: A total of 491 arteriovenous fistulas were placed in 395 patients. Six-, 12-, and 18-mo secondary patency and functional patency were 75 ؎ 2.0, 70 ؎ 2.3, and 67 ؎ 2.7% and 90 ؎ 1.9, 88 ؎ 2.2, and 86 ؎ 2.7%, respectively. Primary failure rate was 40%. Thrombosis rate was 0.14 per patient-year. Diabetes and arteriovenous fistula surveillance were significantly associated with primary functional patency loss. Preoperative duplex was inversely related to secondary failure. The secondary failure rate per hospital varied from 0 to 39%.Conclusions: This study showed a marked difference between patency and functional patency, likely to be explained by high primary failure rates. Hemodialysis patients with diabetes can be expected to have reduced primary functional patency rates, but if treated adequately, then arteriovenous fistula functionality can be maintained as long as in patients without diabetes.

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“…Although the radiocephalic fistulae provides an adequate flow that improves over time with the maturation of the fistulae (Golledge et al 1999;Rooijens et al 2004), some authors suggest that this approach is associated with problems such as high incidence of early occlusion and low flow rate (Dixon et al 2002), particularly more frequently in end-to-side anastomosis compared to side-to-side anastomoses. In theory, end-to-side anastomoses are able to convey less blood compared to side-to-side anastomoses (Thomsen et al 1983).…”

Section: Discussionmentioning

confidence: 99%

“…Patients with chronic renal failure are dependent on hemodialysis and need appropriate vascular access sites (Rooijens et al 2004).…”

confidence: 99%

“…Although access sites in the lower extremities are preferable with respect to better blood flow, technical difficulties and the risk of infection limit their use. AVF in the upper extremities should be created starting from the most distal anatomical location due to the possibility of future use of proximal sites (Rooijens et al 2004).…”

confidence: 99%

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Primary and Secondary Patency Rates and Complications of Upper Extremity Arteriovenous Fistulae Created for Hemodialysis

Ateş

Özyazicioğlu

Yekeler

et al. 2006

Tohoku J. Exp. Med.

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ATES, A., ÖZYAZICIOĞLU, A., YEKELER, I., CEVIZ, M., ERKUT, B., KARAPOLAT, S., KOÇOĞULLARI, C.U. The types of fistulae used and their complication rates are important for the hemodialysis patients. We aimed to compare retrospectively the primary and secondary patency rates and complications of upper extremity arteriovenous fistulae. Between 1984 and 2005, a total of 1,233 upper extremity arteriovenous fistulae were created in 920 patients. The mean age was 42 ± 21 years. The fistulae were divided into the 3 groups; 588 radiocephalic, 205 brachiocephalic, and 127 were created by polytetrafluoroethylene graft. The fistulae types were evaluated with regard to their primary-secondary patency rates and complications. There was a significant difference with regard to development of thrombosis in radiocephalic group compared to other two groups, respectively, p = 0.0122, p = 0.0091. In brachiocephalic fistulae group, edema and steal phenomenon were statistically significant ( p < 0.0001). The aneurysm formation was statistically significant in polytetrafluoroethylene fistulae graft group ( p < 0.0001). During 6 months, 2 and 5 years period, while primary patency rate was higher in three fistulae types, in radiocephalic fistulae both primary and secondary fistulae patency rates were lower ( p < 0.05). To create successful arteriovenous fistulae with long-term patency, appropriate veins of patients should be carefully preserved; thus initially a distal site should be preferred, and in case of failure the next fistulae should be created proximally. In case of failure of forearm fistulae, primary fistulae with autogenous veins should be tried at the upper arm first, and if this also fails, fistulae formation with synthetic grafts should be considered. arteriovenous fistulae; upper extremity; surgical techniques; patency rate

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Radiocephalic Wrist Arteriovenous Fistula for Hemodialysis: Meta-analysis Indicates a High Primary Failure Rate

Abstract: Although, the autogenous RCAVF is considered to be the primary choice for vascular access, this meta-analysis indicates a high primary failure rate and only moderate patency rates at 1 year of follow-up.

Cited by 278 publications

References 33 publications

Clinical profile and early outcome of arteriovenous fistula creation for haemodialysis: Integrated activity in a general surgery unit

Clinical profile and early outcome of arteriovenous fistula creation for haemodialysis: Integrated activity in a general surgery unit

Hemodialysis Arteriovenous Fistula Patency Revisited

Primary and Secondary Patency Rates and Complications of Upper Extremity Arteriovenous Fistulae Created for Hemodialysis

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