PRA-AVFs offer excellent functional patency with low risk of dialysis access-related steal syndrome. The antecubital site has a wide range of venous outflow options for both direct PRA-AVFs and transposition procedures.
The purpose of this study was to compare the clinical outcomes of Ellipsys with those of WavelinQ-4F percutaneous arteriovenous fistulae (pAVF) devices in a single center by a single operator. Materials and Methods: A retrospective review was conducted in 100 patients who underwent pAVFs procedures (65 Ellipsys and 35 WavelinQ patients) and created between December 2017 and December 2019. A total of 69% were male and 37% were diabetic. Median age was 64.1 years (range: 28-86), and median body mass index was 27.2 (range: 15-45.1) kg/m 2. A procedure sequence algorithm was followed for selecting all vascular accesses created. Results: Ellipsys outcomes were compared to WavelinQ outcomes. Technical success was 100% versus 97%, respectively, and median procedure times were 14 versus 63 minutes, respectively (P < .001), with 183 (1-487) versus 185 (0-760) days follow-up, respectively. Maturation at 4 weeks was 68.3% versus 54.3%, respectively, and median times to cannulation were 60 (1-164) versus 90 (1-180) days, respectively. Successful pAVF dialysis was established in 31 of 39 patients (79.5%) versus 14 of 24 patients (58%), respectively (P ¼ .071), dialysis patients with access-related adverse events observed in 4 individuals (1 Ellipsys versus 3 WavelinQ). Six patients (5 versus 1) with matured outflow from previous AVFs underwent first-day cannulations. Interventions were performed in 27.7% (33 Ellipsys) and 26.5% (15 WavelinQ) patients, and the number of interventions per patient-years was 0.96 versus 0.46, respectively. pAVF failure was seen in 15.4% versus 37.1% patients, respectively (P ¼ .0137). Secondary patency at 12 months was significantly higher among patients who had an Ellipsys procedure (82%) than among those who underwent the WavelinQ procedure (60%). Conclusions: pAVFs were created with high technical success and low complications with both devices. Ellipsys pAVFs demonstrated significantly shorter procedure times without a need for radiation exposure and with superior secondary patency. ABBREVIATIONS DCV ¼ deep communicating vein, pAVF ¼ percutaneous arteriovenous fistulae, PRA ¼ proximal radial artery, sAVF ¼ surgically created arteriovenous fistulae Early results with newly approved devices to create percutaneous arteriovenous fistulae (pAVF) suggest that they may offer improved outcomes compared to open surgical AFV (sAVF) access without compromising conventional surgical sites for future dialysis access creation (1-6). Two such devices have been certified by Conformit e Europ eenne and approved by US Food and Drug Administration, the WavelinQ-4F system (Beckton Dickinson, Franklin Lakes,
Background. The current study describes concurrent use of cigarettes and smokeless tobacco (CiST) among males and females and evaluates factors associated with CiST use. Methods. Cross-sectional data were drawn from the 2010 Behavioral Risk Factor Surveillance System (BRFSS). Weighted stratified analyses were performed to find associations between CiST use and sociodemographic factors by gender. CiST users were compared to three different tobacco use groups: nonusers, exclusive smokers, and exclusive ST users. Results. Younger age and heavy alcohol consumption were consistently associated with increased odds of CiST use among both males and females, and regardless of comparison group. Among males, education was inversely related to CiST use, and these findings were consistent in all three comparisons. Among women, those unable to work or out of work were more likely to be CiST users, which was consistent across comparisons. American Indian females had higher odds of CiST use than White females when nontobacco users or smokers were the comparison group. Conclusion. This study identified sociodemographic characteristics associated with CiST use, and differences in these associations among women and men. Additionally, this study highlights the need to carefully consider what comparison groups should be used to examine factors associated with CiST use.
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