Impact of a preoperative evaluation on the outcomes of an arteriovenous fistula

Sung Min Kim; Youngjin Han; Hyunwook Kwon; Hee Sun Hong; Ji Yoon Choi; Hojong Park; Tae-Won Kwon; Yong-Pil Cho

추천

검색

질문

자료유형: 학술저널

저자정보: Sung Min Kim (University of Ulsan) Youngjin Han (University of Ulsan) Hyunwook Kwon (University of Ulsan) Hee Sun Hong (University of Ulsan) Ji Yoon Choi (University of Ulsan) Hojong Park (Ulsan University Hospital) Tae-Won Kwon (University of Ulsan) Yong-Pil Cho (University of Ulsan)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.90 No.4

발행연도: 2016.4

수록면: 224 - 230 (7page)

이용수

📌

연구주제

📖

연구배경

🔬

연구방법

🏆

연구결과

초록· 키워드

오류제보하기

Purpose: The aim of this study was to determine the possible predictors of primary arteriovenous fistula (AVF) failure and examine the impact of a preoperative evaluation on AVF outcomes.
Methods: A total of 539 patients who underwent assessment for a suitable site for AVF creation by physical examination alone or additional duplex ultrasound were included in this study. Demographics, patient characteristics, and AVF outcomes were analyzed retrospectively.
Results: AVF creation was proposed in 469 patients (87.0%) according to physical examination alone (351 patients) or additional duplex ultrasound (118 patients); a prosthetic arteriovenous graft was initially placed in the remaining 70 patients (13.0%). Although the primary failure rate was significantly higher in patients assessed by duplex ultrasound (P = 0.001), ultrasound information changed the clinical plan, increasing AVF use for dialysis, in 92 of the 188 patients (48.9%) with an insufficient physical examination. Female sex and diabetes mellitus were risk factors significantly associated with primary AVF failure. Because of different inclusion criteria and a lack of adjustment for baseline differences, Kaplan-Meier survival analysis showed better AVF outcomes in patients assessed by physical examination alone; an insufficient physical examination was the only risk factor significantly associated with AVF outcomes.
Conclusion: Routine use of duplex ultrasound is not necessary in chronic kidney disease patients with a satisfactory physical examination. Given that female gender and diabetes mellitus are significantly associated with primary AVF failure, duplex ultrasound could be of particular benefit in these subtypes of patients without a sufficient physical examination.

#Renal dialysis #Chronic kidney failure #Treatment outcome #Physical examination #Ultrasonography

참고문헌 (22)

참고문헌 신청

Dageforde LA, Harms KA, Feurer ID, Shaffer D. Increased minimum vein diameter on preoperative mapping with duplex ultrasound is associated with arteriovenous fistula maturation and secondary patency. J Vasc Surg 2015;61:170-6.

Sidawy AN, Spergel LM, Besarab A, Allon M, Jennings WC, Padberg FT Jr, et al. The Society for Vascular Surgery: clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access. J Vasc Surg 2008;48(5 Suppl):2S-25S.

Rooijens PP, Tordoir JH, Stijnen T, Burgmans JP, Smet de AA, Yo TI. Radiocephalic wrist arteriovenous fistula for hemodialysis: meta-analysis indicates a high primary failure rate. Eur J Vasc Endovasc Surg 2004;28:583-9.

Long B, Brichart N, Lermusiaux P, Turmel- Rodrigues L, Artru B, Boutin JM, et al. Management of perianastomotic stenosis of direct wrist autogenous radial-cephalic arteriovenous accesses for dialysis. J Vasc Surg 2011;53:108-14.

Saucy F, Haesler E, Haller C, Déglise S, Teta D, Corpataux JM. Is intra-operative blood flow predictive for early failure of radiocephalic arteriovenous fistula? Nephrol Dial Transplant 2010;25:862-7.

함께 읽어보면 좋을 논문

논문 유사도에 따라 DBpia 가 추천하는 논문입니다. 함께 보면 좋을 연관 논문을 확인해보세요!