Salvage of the nonfunctioning arteriovenous fistula

Beathard, Gerald A.; Settle, Stephen M.; Shields, Marty W.

doi:10.1016/s0272-6386(99)70425-7

Cited by 203 publications

(146 citation statements)

References 12 publications

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“…Several decades ago, AVF had acceptable primary failure rates of approximately 10% (16 -19) and 1-yr primary patency rates between 70 and 80%. Now, primary failure rates range between 30 and 70% and have primary (32,34,35), it will take an additional 3 mo, on average, until the AVF are sufficiently developed for cannulation (31). The greatest rate of CVC use after AVF creation has been reported at 6 mo (36).…”

Section: Fistula First: a Landmark Initiative To Improve Va Carementioning

confidence: 99%

“…When AVF primary failure occurs, the costs are more than doubled (40,62) (costs of CVC complications not included). However, AVF intervention is effective (approximately 80%) (34,63) and necessary in approximately one third of patients to achieve FFI objectives. An AVF that can be created and then functions without intervention is the most cost-effective (US$4862/yr) (40), but such a scenario occurs in only 40% (32) of AVF.…”

Section: Impact On the Health Care Systemmentioning

confidence: 99%

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Fistula First Initiative

Lok¹

2007

Clinical Journal of the American Society of Nephrology

268

231

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Section: Fistula First: a Landmark Initiative To Improve Va Carementioning

confidence: 99%

Section: Impact On the Health Care Systemmentioning

confidence: 99%

Fistula First Initiative

Lok¹

2007

Clinical Journal of the American Society of Nephrology

268

231

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“…Success rates are dismal (11,21,(52)(53)(54) because vessel injury to the endothelium and smooth muscle cells within the media that occurs after the PTA leads to further development of neointimal hyperplasia and restenosis (13,55). This suggests that although PTA may be important to treat stenosis in AVF and AVG, drug therapies may need to be applied to the site of angioplasty and endothelial injury to promote vascular healing and prolong vascular access patency.…”

Section: Endovascular Therapiesmentioning

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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“…More often than not, this lesion can be adequately treated with angioplasty [111,112] or by surgical revision [113]. Outflow problems may include accessory veins that divert blood flow from the intended superficial vessel to deeper conduits, or central venous stenosis in patients with prior central venous catheters.…”

Section: Arteriovenous Fistulas Complicationsmentioning

confidence: 99%