Endovascular treatment of hemodialysis arteriovenous fistulas: is immediate post-interventional blood flow a predictor of patency.
| Autor: | Heerwagen ST; Department of Radiology, Rigshospitalet, Copenhagen, Denmark. thorupheerwagen@gmail.com, Hansen MA, Schroeder TV, Ladefoged SD, Lönn L |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | The journal of vascular access [J Vasc Access] 2012 Jul-Sep; Vol. 13 (3), pp. 315-20. |
| DOI: | 10.5301/jva.5000046 |
| Abstrakt: | 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. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|