Vascular Access for Hemodialysis Patency Rates and Results of Revision

Palder, Steven B.; Kirkman, Robert L.; Whittemore, A. D.; Hakim, Raymond M.; Lazarus, J. Michael; Tilney, Nicholas L.

doi:10.1097/00000658-198508000-00015

Cited by 487 publications

(212 citation statements)

References 11 publications

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“…The reported complication rates in AVF vary between 21% and 64% (Palder et al 1985), which is similar to that observed in our study. Our results did not show that the complication rate for PTFE grafts was higher than brachiocephalic fistulae, which is consistent with one report (Salahi et al 2006) but opposite to another report (Modarai et al 2005).…”

Section: Discussionsupporting

confidence: 91%

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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Section: Discussionsupporting

confidence: 91%

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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“…This conclusion can vary and depends on many factors, including the definition of access survival, and the age and quality, presentation, and interpretation of the data. For example, the K/DOQI VA guidelines stated that AVF have "excellent patency once established" and "lower complication rates" (14), whereas one study referenced stated "the patency rate of PTFE grafts was significantly (P Ͻ 0.01) better than that for endogenous fistulae" (69). Figure 5 demonstrates superior graft cumulative patency compared with AVF.…”

Section: Impact On the Patient: The Patient Is Firstmentioning

confidence: 99%

Fistula First Initiative

Lok¹

2007

Clinical Journal of the American Society of Nephrology

276

231

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“…In patients who have exhausted all options for an upper extremity fistula or graft, placement of a thigh graft is a viable option (3,4). Although thrombosis is the most common complication of grafts, infection is also relatively frequent, affecting 9% to 20% of grafts (5)(6)(7)(8)(9)(10)(11). Graft infections can result in long hospitalizations, serious complications, and prolonged catheter dependence (12).…”

Section: Introductionmentioning

confidence: 99%

Arteriovenous Graft Infection

Harish

Allon

2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives There are a limited number of publications on the features of arteriovenous graft infection in hemodialysis patients. The authors compared the clinical presentation, complications, and outcomes of infections of thigh and upper extremity grafts.Design, setting, participants, & measurements The authors queried a prospective access database at a large university medical center and identified 132 patients with graft infections (40 in the thigh and 92 in the upper extremity) requiring surgical excision. The authors collected information regarding the microbiology, complications, and clinical outcomes. ResultsThe two graft groups were similar in age, gender, race, and frequency of diabetes. The median age of infected grafts was 162 days for thigh grafts versus 168 days for upper extremity grafts (P ϭ 0.35). Thigh graft infections were more likely than upper extremity graft infections to be caused by a Gram-negative rod (31% versus 4%; P ϭ 0.003), and more likely to result in a metastatic infection (15% versus 3%; P ϭ 0.02). The duration of hospitalization associated with graft infection was similar (10.8 Ϯ 5.4 versus 8.7 Ϯ 6.3 days; P ϭ 0.09). Finally, median catheter dependence was longer after thigh graft than upper arm graft infections (319 versus 237 days; P ϭ 0.04).Conclusions As compared with upper extremity graft infections, thigh graft infections requiring excision are more likely to be caused by Gram-negative bacteria and to result in serious metastatic complications. These differences may require different empiric antibiotics and a higher index of suspicion for infection in hemodialysis patients with thigh grafts.

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Vascular Access for Hemodialysis Patency Rates and Results of Revision

Cited by 487 publications

References 11 publications

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

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

Fistula First Initiative

Arteriovenous Graft Infection

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