Predicting loss of patency after forearm loop arteriovenous graft

Autor: Osamu Iida, Satoko Suemitsu, Masaaki Murakami, Masahito Miyamoto, Tatsuya Shiraki, Masaaki Izumi, Takeshi Nakanishi, Kotaro Suemitsu
Rok vydání: 2015
Předmět:
Male
Time Factors
Arteriovenous Anastomosis
Brachial Artery
030232 urology & nephrology
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
0302 clinical medicine
Japan
Risk Factors
Brachial artery
Aged
80 and over
Hazard ratio
Graft Occlusion
Vascular
Middle Aged
Forearm
medicine.anatomical_structure
Treatment Outcome
Radial Artery
Cardiology
Female
Cardiology and Cardiovascular Medicine
Blood Flow Velocity
medicine.medical_specialty
Arteriovenous fistula
Prosthesis Design
Veins
03 medical and health sciences
Blood Vessel Prosthesis Implantation
Blood vessel prosthesis
Renal Dialysis
medicine.artery
Internal medicine
medicine
Vascular Patency
Humans
Radial artery
Aged
Proportional Hazards Models
Retrospective Studies
Chi-Square Distribution
business.industry
medicine.disease
Surgery
Blood Vessel Prosthesis
Regional Blood Flow
Multivariate Analysis
business
Zdroj: Journal of vascular surgery. 64(2)
ISSN: 1097-6809
Popis: Objective Although arteriovenous grafts (AVGs) for dialysis access have been applied to patients who were poor candidates for an arteriovenous fistula, durability after AVGs has been clinically suboptimal. This retrospective study investigated whether forearm AVGs based on radial artery inflow would have superior patency to those with brachial artery inflow and evaluated the operative predictors for loss of patency after AVG. Methods This multicenter retrospective study included 156 upper limbs in 150 consecutive patients (50% male; age, 70.5 ± 12.8 years) who underwent forearm loop AVG formation from January 2010 to October 2013. The outcome measures were the primary and secondary functional graft patency rates and factors related to primary patency. Primary and secondary patency of AVGs was evaluated by Kaplan-Meier analysis, and predictors for loss of primary patency of AVGs were determined using a Cox proportional hazards model. Results The median observation period was 10 months (interquartile range, 6-18 months). The 1-year primary patency rate was 32.4%, and the secondary patency rate was 83.4%. Use of the radial artery as the inflow arteriovenous anastomosis (hazard ratio, 0.56; 95% confidence interval, 0.30-0.99) was independently associated as an operative predictor for primary patency after AVG. The primary patency rate was significantly different between radial artery inflow and brachial artery inflow at 1 year (53.8% vs 24.4%; P = .032). Conclusions Radial artery selection as inflow artery was independently associated with primary patency after AVG.
Databáze: OpenAIRE
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