A Review of Arteriovenous Fistulae Creation in Octogenarians.
Ann Vasc Surg
; 46: 331-336, 2018 Jan.
Article
em En
| MEDLINE
| ID: mdl-28743653
ABSTRACT
BACKGROUND:
To analyze the outcomes of arteriovenous fistulae (AVFs) creation in octogenarians.METHODS:
A retrospective study of 47 AVFs created in patients aged 80 years and above from 2008 to 2014. Patient and AVF characteristics and outcomes were evaluated. Predictors of patency were analyzed with multivariate analysis and Kaplan-Meier patency, and survival analysis was performed.RESULTS:
Forty-seven of 1,259 AVFs created were for octogenarians (4%). Mean age was 83 years old (range 80-91 years), with 27 male (57%) and 35 with tunneled dialysis catheters in situ (75%). There were a total of 15 (32%) radiocephalic AVFs, 30 (64%) brachial-cephalic AVFs, and 2 (4%) brachial-basilic transposition AVFs. At 12 months, assisted primary patency rate was 28% (13 patients) while primary failure rate was 72% (34 patients). Subset analysis showed brachial-cephalic AVFs to have the highest assisted primary patency rate at 33%. Within 24 months, tunneled dialysis catheter-related sepsis rate was 31% (11 patients). Multivariate analysis did not reveal any factor to be statistically significant in predicting AVF patency. Kaplan-Meier survival curve showed a 50% survival rate at 63 months after AVF creation.CONCLUSIONS:
In view of high AVF primary failure rate and relatively low tunneled dialysis catheter bacteremia rate, long-term tunneled dialysis catheters as the main form of hemodialysis renal access may be a viable option. However, with 50% of end-stage renal failure patients surviving up to 63 months after AVF creation, the risks and benefits of long-term tunneled dialysis catheters must be balanced against those of AVF creation.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Derivação Arteriovenosa Cirúrgica
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Diálise Renal
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Extremidade Superior
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Falência Renal Crônica
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged80
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article