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Clinical significance of upper-arm cephalic vein patency in autogenous radial-cephalic wrist fistulas for hemodialysis

Authors
Lee, JH; Won, JH; Oh, CK; Jung, HA
Citation
European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 44(5):514-520, 2012
Journal Title
European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
ISSN
1078-58841532-2165
Abstract
OBJECTIVES: To investigate the significance of upper-arm cephalic veins (UACVs) in radial-cephalic arteriovenous fistulas (RCAVFs), the medical records of 183 patients who had undergone RCAVF creation were reviewed retrospectively.



METHODS: The patients were divided into two groups according to the status of the UACV upon preoperative venography: group A of 153 cases (83.6%) with a patent UACV and group B of 30 cases (16.3%) with a stenosed or occluded UACV. The clinical outcomes were compared.



RESULT: RCAVFs in group B had a significantly higher maturation failure rate (26.7% vs. 9.8%, p = 0.009) and lower primary/secondary patency rates (log-rank test, p < 0.0001) than those in the group A. The patients in group B required more frequent endovascular intervention to maintain access function (p = 0.002). The most common stenosis site was a draining vein in group B, in comparison to juxta-anastomosis in group A. In the multivariate analyses, the status of the UACV was an independent predictor of the primary and secondary patency rates of RCAVFs (p < 0.005).



CONCLUSION: UACV patency has a significant impact on clinical outcome for RCAVFs. When planning an RCAVF placement, venous status including the UACV should be considered.
MeSH terms
AdultAgedArteriovenous Shunt, Surgical/*adverse effectsChi-Square DistributionConstriction, PathologicEndovascular ProceduresFemaleGraft Occlusion, Vascular/*etiology/physiopathology/radiography/therapyHumansKaplan-Meier EstimateMaleMiddle AgedMultivariate AnalysisPhlebographyProportional Hazards ModelsRadial Artery/physiopathology/*surgery*Renal DialysisReoperationRepublic of KoreaRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment Outcome*Vascular PatencyVeins/physiopathology/surgeryWrist/*blood supply
DOI
10.1016/j.ejvs.2012.08.017
PMID
23022033
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
AJOU Authors
이, 종훈원, 제환오, 창권
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