Changes in the practice of angioaccess surgery: Impact of dialysis outcome and quality initiative recommendations

Ascher, Enrico; Gade, Prasad; Hingorani, Anil; Mazzariol, Fernanda S.; Gunduz, Yilmaz; Fodera, Maria; Yorkovich, William

doi:10.1016/s0741-5214(00)70070-x

Cited by 234 publications

(151 citation statements)

References 11 publications

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“…Of these, the native arteriovenous fistula is preferred for long-term hemodialysis vascular access since it has the best long-term primary patency rate, requires the fewest interventions of any type of access, and most importantly, arteriovenous fistulas are associated with the lowest incidence of morbidity and mortality. [3][4][5][6][7] The benefits of arteriovenous fistulas over other forms of chronic access are: Arteriovenous fistulas are associated with decreased morbidity and mortality among hemodialysis patients compared with arteriovenous grafts and central venous catheters. [8][9][10] Arteriovenous fistulas have the superior primary patency rates, the lowest rates of thrombosis, and require the fewest secondary interventions.…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of radiocephalic versus brachiocephalic native arteriovenous fistula for hemodialysis in end stage renal disease

et al. 2016

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Background: Chronic kidney disease (CKD) is a long term condition caused by damage to both kidneys. The benefits of arteriovenous fistulas over other forms of chronic access are: Arteriovenous fistulas are associated with decreased morbidity and mortality among hemodialysis patients compared with arteriovenous grafts and central venous catheters. Objectives of the study were o choose the proper sites for formation of arteriovenous fistula, to find out the success rate at various sites and to study the complications of arteriovenous fistula.Methods: This prospective study was carried out on total 150 patients over the duration of two years. The fistulae were created using radial artery and cephalic vein side to side (Radiocephalic AVF) and brachial artery and cephalic vein side to side anastomosis (Brachiocephalic AVF). Doppler studies were done before and after every procedure to demonstrate the velocity, volume of blood flow, depth from the skin, diameter of vessels and to access the time of maturation of AVF. Patients were followed up to first dialysis by AVF to assess the overall outcomes and various complications.Results: Brachiocephalic AVF matured earlier than Radiocephalic AVF (mean maturation time Brachiocephalic 38.02 days and Radiocephalic 43.26 days) which was statistically significant. Brachiocephalic AVF matured earlier than Radiocephalic AVF with more flow rate. Complication rate was more at wrist (Radiocephalic AVF with 66.67% of overall complication) than at elbow (Brachiocephalic AVF with 33.33% of overall complication).Conclusions: We concluded that the Brachiocephalic AVF maturation time was significantly less than the maturation time of Radiocephalic AVF and rate of complication was less in Brachiocephalic AVF. The utility of pre-operative colour Doppler to select the vessels for AVF creation was found to be as an essential parameter of pre-operative work up.

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Section: Introductionmentioning

confidence: 99%

Comparative analysis of radiocephalic versus brachiocephalic native arteriovenous fistula for hemodialysis in end stage renal disease

et al. 2016

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“…[3][4][5][6][7] The major factor limiting fistula use for dialysis is the high rate of primary failure (fistulas that are never usable for dialysis) due to either early thrombosis or inadequate maturation. 2 The primary failure rate is higher in women than in men and higher in forearm than in upper arm fistulas.…”

mentioning

confidence: 99%

Preoperative Sonographic Radial Artery Evaluation and Correlation With Subsequent Radiocephalic Fistula Outcome

Lockhart

Robbin

Allon

2004

Journal of Ultrasound in Medicine

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Objective. Primary failure of forearm radiocephalic dialysis fistulas is common even when preoperative vascular mapping is used. Previous studies have suggested that low peak systolic velocity of the radial artery predicts subsequent fistula failure. The study goal was to evaluate whether preoperative spectral Doppler assessment of radial artery inflow can improve forearm fistula outcome prediction. Methods. Forearm fistulas were placed in 112 patients after preoperative sonographic mapping. Preoperative spectral Doppler sonography measured radial artery peak systolic velocity during tight fist clenching for 3 minutes and after fist relaxation. Vessel diameters and peak systolic velocity were assessed for predictive value based on subsequent fistula adequacy. Fistula flow rates were determined 6 to 12 weeks postoperatively in a subset of patients. Results. Failed and successful fistulas were similar in their preoperative arterial and vein diameters, resistive index, and peak systolic velocity during fist clenching and after fist relaxation. Specifically, there was no difference in fistula success with radial artery peak systolic velocity lower than 50 cm/s versus peak systolic velocity of 50 cm/s or higher. The change in peak systolic velocity after fist relaxation was highly predictive of subsequent fistula outcome among female patients in ad hoc analysis. Fistula adequacy for dialysis in women was 11% when the change in peak systolic velocity was lower than 0 cm/s and 50% when the change was 0 cm/sec or higher (P = .02). The postoperative fistula flow rates were lower when the preoperative change in peak systolic velocity was lower than 0 cm/s than when it was 0 cm/s or higher (316 ± 46 versus 781 ± 150 mL/min; P = .003). Conclusions. There was no difference in the preoperative peak systolic velocity or the resistive index of successful and failed fistulas. Measurement of the radial artery peak systolic velocity change after release of fist clenching was not useful in predicting outcomes in male patients but identified a subset of female patients with a very low likelihood of success. This criterion may merit further investigation in future trials.

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“…In the mid-1990s, the situation was reviewed in the U.S., following the DOQI recommendation, and revival of the autogenous fi stulas took place due to less proneness to stenoses, thromboses and infectious complications in comparison with the grafts. It was recommended that at least 50 % of the fi stulas created was autogenous 2,11 . A summary of the observations of both access types in the U.S. shows that both fi stula types have a comparable operating duration, with the advantage of autogenous fi stulas being the lower number of post-maturity complications and fi stula interventions.…”

Section: Resultsmentioning

confidence: 99%

“…The steal syndrome shows early manifestations in fi stulas performed with a graft as opposed to their later manifestation in autogenous fi stulas in connection with fi stula development 23 . Diabetes mellitus is considered a risk factor for the occurrence of this complication 11,16,[24][25][26][27][28] . However, some authors do not agree 29 .…”

Section: Resultsmentioning

confidence: 99%

Autogenous Arteriovenous Elbow Fistula for Haemodialysis and Upper Extremity Ischemia

Bachleda¹,

Utíkal²,

Kojecký³

et al. 2007

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background:The autogenous brachiocefalic or brachiobasilic arteriovenous elbow fi stula is not considered to be only the secondary haemodialysis access. In patients with an unsuitable forearm vessel bundle, it is indicated as primary access and it is the method preferred to the fi stula creation using a vascular prosthesis. Its rather rare complication is the development of upper extremity ischemia.Aim: To summarise current knowledge of this fi stula type and its associated complications Methods: Review of the literature. Results:The creation and maturation of the fi stula and occurrence of the steal syndrome is infl uenced by a number of factors. The analysis and awareness of such factors will provide for creation of a suitable fi stula as well as for timely complication diagnostics and treatment.Conclusions: The autogenous elbow fi stula utilising the brachial artery and the cephalic or basilic vein in the upper extremity represents a high-quality haemodialysis access. Its potential complication is the occurrence of the steal syndrome. Its occurrence and manifestations do not constitute indications for ligation of the access. The gathered information shows that a suitable surgical procedure can help meet the basic rule for haemodialysis access -resolving the ischemia and maintaining the access.

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Changes in the practice of angioaccess surgery: Impact of dialysis outcome and quality initiative recommendations

Cited by 234 publications

References 11 publications

Comparative analysis of radiocephalic versus brachiocephalic native arteriovenous fistula for hemodialysis in end stage renal disease

Comparative analysis of radiocephalic versus brachiocephalic native arteriovenous fistula for hemodialysis in end stage renal disease

Preoperative Sonographic Radial Artery Evaluation and Correlation With Subsequent Radiocephalic Fistula Outcome

Autogenous Arteriovenous Elbow Fistula for Haemodialysis and Upper Extremity Ischemia

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