Impaired hyperemic response is predictive of early access failure

Annals of Vascular Surgery
L Philipp WallJohn Ricotta

Abstract

The aim of this study was to demonstrate that hyperemic response is a predictor of access failure. We conducted a review of a prospective database of dialysis access patients with preoperative hyperemia studies from June 1998 to August 2002. These consisted of bilateral brachial artery pressures followed by flow velocity measurements of the brachial artery and radial artery at rest and after 3 min of arm ischemia. Measurements were taken by using a cuff placed above the antecubital fossa and inflated to 20 mmHg above systolic pressure. There were no differences recorded in brachial artery pressures for the bilateral studies. Hyperemic response was entered into a stepwise Cox regression to determine its effect on access failure. Access failure was defined as failure to mature or thrombosis. Accesses were placed according to Dialysis Outcome Quality Intiatives (DOQI) guidelines. Kaplan-Meier survival analysis was performed. Log-rank testing was used to compare patency results. Censored end points were death, renal transplant, and access survival to the end of the study period. Fistulas that failed to mature were considered failures at 3 months. Arteries with a <5 cm/sec increase in peak systolic velocity were defined as nonrespon...Continue Reading

References

Feb 12, 1998·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·R JoannidesC Thuillez
Sep 10, 2002·Journal of Vascular Surgery·Robert R MendesSteven J Burnham

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Citations

Jun 3, 2015·Clinical Kidney Journal·Damian G McGroganNicholas G Inston
Nov 11, 2011·Journal of Vascular Surgery·George E SmithIan C Chetter
Nov 22, 2005·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·C P Gibbons
Jun 18, 2016·The Journal of Vascular Access·Patrícia BarretoAntónio Cabrita
Mar 16, 2017·The Journal of Vascular Access·Jernej Pajek, Marko Malovrh
Jan 5, 2011·Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery·C MamaisB Nirmal Kumar
Apr 22, 2020·Journal of Aging and Physical Activity·Luca PolloniniStacey L Gorniak
Sep 28, 2021·The Journal of Vascular Access·Joaquim VallespinJose Ibeas

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