| Endovascular treatment of hemodialysis arteriovenous fistulas: is immediate post-interventional blood flow a predictor of patency. | |
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MedLine Citation:
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PMID: 22266582 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Purpose: The purpose of this study was to investigate if the immediate hemodynamic outcome of an endovascular intervention on a dysfunctional hemodialysis arteriovenous fistula is a prognostic factor for primary patency. Methods: This was a prospective observational study including 61 consecutive patients with dysfunctional arteriovenous fistulas referred to our endovascular unit. Patients were treated in accordance with institutional standard protocol including immediate pre- and post-interventional blood flow measurements using an intravascular catheter system. The primary endpoint was primary patency at 12 months in patients with an immediate post-interventional blood flow above or below 600 ml/min. Primary patency was estimated using the Kaplan-Meier method with the standard error of the estimate. Multivariate Cox regression analysis was used to study the effect of blood flow and other potential predictor variables. Results: Post interventional flow did not significantly influence primary patency (p = 0.76). Primary patency was found to be affected by having a history of previous intervention(s) (p = 0.008, hazard ratio 2.9) or low fistula age (P=.038, hazard ratio 0.97 [one-month increase]). Primary patency in group 1 (previous intervention(s)) was 34% ± 13% at 12 months. In group 2 (no previous intervention), primary patency at 12 months was 62% ± 9%. Conclusions: The results of this study do not provide scientific support for using the immediate hemodynamic outcome of an intervention as a prognostic factor for primary patency. Low fistula age and a history of previous intervention in particular were found to reduce primary patency significantly. |
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Authors:
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Søren T Heerwagen; Marc A Hansen; Torben V Schroeder; Søren D Ladefoged; Lars Lönn |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-18 |
Journal Detail:
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Title: The journal of vascular access Volume: - ISSN: 1724-6032 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100940729 Medline TA: J Vasc Access Country: - |
Other Details:
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Languages: ENG Pagination: 0 Citation Subset: - |
Affiliation:
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Department of Radiology, Rigshospitalet, Copenhagen - Denmark. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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