Clinical Utility of a New Predicting Score for Radiocephalic Arteriovenous Fistula Survival.
Ann Vasc Surg
; 41: 56-61, 2017 May.
Article
em En
| MEDLINE
| ID: mdl-28238926
ABSTRACT
BACKGROUND:
Radiocephalic arteriovenous fistula (RC-AVF) is the recommended first choice for vascular access (VA). The CAVeA2T2 scoring system was recently published (ipsilateral central venous catheter access, age >73 years, vein <2.2 mm, lower limb angioplasty, and absent intraoperative thrill). The aim of the present study was to assess the clinical utility of the CAVeA2T2 scoring system for predicting RC-AVFs survival in our center and its subsequent application in VA management. MATERIAL ANDMETHODS:
In this single-center retrospective study, all RC-AVFs performed from January 2010 to July 2014 were included. The CAVeA2T2 was applied. Primary, assisted primary, and secondary patency rates were measured.RESULTS:
Sixty RC-AVFs were analyzed. Mean age was 64.3 ± 14.7 years. Mean CAVeA2T2 score was 1.23 ± 1.2. The median fistula secondary patency was 13.7 ± 1.6 months. Secondary patency was at 6 weeks and at 6, 12, and 24 months 88.3%, 66.7%, 55%, and 31.7%, respectively. Increasing score (≥2) was associated with a decrease in primary (log-rank, χ2 = 16.7, dif = 1, P = 0.0001) and secondary patency rate survival (log-rank, χ2 = 5.4, dif = 1, P = 0.0001). In addition, stratification of the CAVeA2T2 score into 3 groups (scores 0-1, 2, and 3+) retained its significance for primary (log-rank, χ2 = 19.4, dif = 2, P = 0.0001) and secondary patency rate survival (log-rank, χ2 = 5.5, dif = 2, P = 0.046) at the end of the study.CONCLUSIONS:
In the present study, the CAVeA2T2 scoring system has proved to be a useful, easy to apply tool that is highly predictive of RC-AVF survival. Based on our results, we should avoid perform RC-AVFs, in those patients with CAVeA2T2 score ≥2 and late nephrology referral. Prospective studies should be designed to establish the management of patients with a higher CAVeA2T2 score.
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Base de dados:
MEDLINE
Assunto principal:
Veias
/
Derivação Arteriovenosa Cirúrgica
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Técnicas de Apoio para a Decisão
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Diálise Renal
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Artéria Radial
/
Extremidade Superior
Tipo de estudo:
Etiology_studies
/
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
/
Middle aged
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article