Vascular access-related complications are an important cause of morbidity, and they account for 14% to 17% of dialysis patients' hospitalizations with an annual cost in the United States of approximately $1 billion. Previous studies have related the major predisposing factor of thrombotic complications to stenosis of the graft anastomosis. Several recent reports suggest that antiphospholipid antibodies may cause frequent thrombotic complications. The broad spectrum of diseases that cause hypercoagulable states has not been correlated with frequent PTFE graft thrombosis. A retrospective case series study was performed to determine the frequency of hypercoagulable states in dialysis patients who had repeated thrombotic complications of their PTFE grafts. Between May 1996 and June 1998, 91 operations were performed on 34 patients with end-stage renal disease. All arteriovenous fistulas were created with PTFE grafts and placed by a single surgeon. All patients were evaluated at operation for anastomotic stenosis, and the majority of patients were studied for hypercoagulable states. Patients with a documented hypercoagulable state were considered for warfarin therapy. Twenty-two individuals (64.7%) developed 67 thrombotic complicati...Continue Reading
Intimal fibromuscular hyperplasia at the venous anastomosis of PTFE grafts in hemodialysis patients. Clinical, immunocytochemical, light and electron microscopic assessment
Anticardiolipin antibody in patients on maintenance hemodialysis and its association with recurrent arteriovenous graft thrombosis
Comparison of the primary and secondary antiphospholipid syndrome: a European Multicenter Study of 114 patients
The economic cost of ESRD, vascular access procedures, and Medicare spending for alternative modalities of treatment. USRDS. United States Renal Data System
Alternative methods of anticoagulation for dialysis-dependent patients with heparin-induced thrombocytopenia
Should patients with advanced chronic kidney disease and atrial fibrillation receive chronic anticoagulation?
Adhesion and activation of platelets from subjects with coronary artery disease and apparently healthy individuals on biomaterials
Efficacy of axillary-to-femoral vein bypass in relieving venous hypertension in dialysis patients with symptomatic central vein occlusion
Are hemodialysis access flow measurements by ultrasound dilution the standard of care for access surveillance?
Platelet adhesion testing may predict early hemodialysis arteriovenous graft and fistula failure in end-stage renal disease patients
A prospective study of the prevalence of heparin-induced antibodies and other associated thromboembolic risk factors in pediatric patients undergoing hemodialysis
The relationship between anticardiolipin antibodies and vascular access occlusion in patients on hemodialysis
Thrombosis of tunneled-cuffed hemodialysis catheters: treatment with high-dose urokinase lock therapy
Thrombophilic risk factors in hemodialysis: Association with early vascular access occlusion and patient survival in long-term follow-up
The presence of PAI-1 4G/5G and ACE DD genotypes increases the risk of early-stage AVF thrombosis in hemodialysis patients
Outcomes of arteriovenous grafts following simultaneous thrombectomy and stent graft placement across the venous anastomosis
Association between vascular access failure and the use of specific drugs: the Dialysis Outcomes and Practice Patterns Study (DOPPS)
Secondary patency of thrombosed prosthetic vascular access grafts with aggressive surveillance, monitoring and endovascular management
Antiphospholipid syndrome or antiphospholipid antibody syndrome (APS or APLS), is an autoimmune, hypercoagulable state caused by the presence of antibodies directed against phospholipids.