• Media type: E-Article
  • Title: Factors associated with outcome after successful radiological intervention in arteriovenous fistulas: A retrospective cohort
  • Contributor: Manou-Stathopoulou, Sotiria; Robinson, Emily J; Harvey, John Julian; Karunanithy, Narayan; Calder, Francis; Robson, Michael G
  • imprint: SAGE Publications, 2019
  • Published in: The Journal of Vascular Access, 20 (2019) 6, Seite 716-724
  • Language: English
  • DOI: 10.1177/1129729819845991
  • ISSN: 1129-7298; 1724-6032
  • Keywords: Nephrology ; Surgery
  • Origination:
  • Footnote:
  • Description: <jats:sec><jats:title>Introduction:</jats:title><jats:p> Arteriovenous fistulas are the best form of vascular access for haemodialysis. A radiological balloon angioplasty is the standard treatment for a clinically relevant stenosis, but the recurrence rate is high. Data on factors associated with recurrence are limited. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> A single centre, retrospective analysis was performed for 124 consecutive patients who had successful interventions for dysfunctional arteriovenous fistulae, to examine factors associated with post-intervention patency. Follow-up was at least 1 year for all patients. Variables associated with primary and cumulative patency were pre-specified and assessed using both un-adjusted (univariate) and adjusted Cox proportional hazards models. Analysis was repeated for a subgroup of 80 patients with a single lesion only in order to examine the potential effects of stenotic lesion characteristics on patency. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> Factors found to have a significant association with poorer outcomes (less time to loss of patency) included thrombosis at the time of intervention and a history of previous intervention. Fistula age (log days) was significantly associated with better outcomes (greater time to loss of patency). Non-white ethnicity, lesion length, and patient age were also significantly associated with accelerated loss of patency. </jats:p></jats:sec><jats:sec><jats:title>Discussion:</jats:title><jats:p> The factors we have identified as linked to poor outcome may help to identify patients in whom a balloon angioplasty is unlikely to provide a durable outcome. This may prompt exploring alternative treatment or dialysis options at an early stage. </jats:p></jats:sec>