Successful Access Rate and Risk Factor of Vascular Access Surgery in Arm for Dialysis

Dae Woo Yoo; Myunghee Yoon; Hee Jae Jun

doi:10.5758/vsi.2014.30.1.33

Original Article

Successful Access Rate and Risk Factor of Vascular Access Surgery in Arm for Dialysis

Dae Woo Yoo¹, Myunghee Yoon², and Hee Jae Jun³

Author Info ⁺

¹Department of Surgery, BHS Hanseo Hospital, Busan, ²Department of Surgery, Kosin University Gospel Hospital, Busan, ³Department of Thoracic and Cardiovascular Surgery, Inje University Haeundae Paik Hospital, Busan, Korea

Correspondence to:

Hee Jae Jun Department of Thoracic and Cardio vascular Surgery, Haeundae Paik Hospital, Inje University, 875 Haeun-daero, Haeundae-gu, Busan 612-896, Korea, Tel: 82-51-797-3131, Fax: 82-51-797-3101, E-mail: cs523@dreamwiz.com

Received: January 3, 2014; Accepted: February 19, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Vascular Specialist International 2014; 30(1): 33-37

Published March 30, 2014 https://doi.org/10.5758/vsi.2014.30.1.33

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Abstract

Go to

Abstract
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
CONCLUSION
Table
References

Purpose:

Preservation of adequate vascular access is of vital importance for patients undergoing chronic dialysis in renal failure. The aim of this study is to evaluate the successful access rate and risk factors of arteriovenous fistula (AVF) in the arm for dialysis at a single center.

Materials and Methods:

Patients undergoing vascular access operation between January 2006 and December 2011 were retrospectively identified.

Results:

A total of 362 vascular access operations were performed. There were 338 autologous AVFs (93.4%) and 24 prosthetic grafts (6.6%). Men comprised 58.3% of all subjects. Mean age was 59.5±14.7 years. There were 187 diabetes mellitus patients (51.7%). There was a mean duration of 70.3±21.1 days between access creation to first cannulation. Overall successful access rate for dialysis was 95.9%. Of 338 autologous AVFs, 326 patients had patent AVFs for dialysis (96.4% surgical success rate), while 21 of 24 prosthetic grafts were patent (87.5% surgical success rate). A total of 141 patients (38.9%) came to surgery with preoperative central venous catheters (CVC) of which 130 (35.9%) AVFs had a patent fistula in the arm. The only risk factor related to successful access rate of AVF was preoperative CVC placement (P=0.012).

Conclusion:

Successful vascular access rate was 95.9%. The only risk factor related to patent access of AVF was preoperative CVC placement. At least 6 months prior to expected dialysis, AVF surgery is recommended, which may overcome the challenge of co-morbid conditions from having a preoperative CVC.

Keywords

Arteriovenous fistula, Patency, Renal insufficiency

INTRODUCTION

Go to

Abstract
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
CONCLUSION
Table
References

The incidence of dialysis-dependent end stage renal failure is increasing. Preservation of adequate vascular access is of vital importance for patients undergoing chronic dialysis in end stage renal disease. Unfortunately, access-related morbidity adds significantly to total annual expenditure on the hemodialysis population and is associated with a poorer long-term prognosis [1,2]. The goal of the dialysis surgeon, therefore, is to create a permanent access which is both effective and durable. The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) standards promote the increase of native vascular access use because of superior patency rates and lower complication rates than grafts once established [3]. However, current hemodialysis patients are older, more often have diabetes and more often have cardiovascular comorbidities [2?4]. Moreover, arteriovenous fistulas (AVF) have high primary failure rates and maturation problems will increasingly challenge vascular access teams in meeting the KDOQI goals [5,6]. Fistula dialysis patients have fewer complications, require a shorter hospital stay and have better overall survival rate than those who dialyze with a tunneled central venous catheter (CVC) or prosthetic graft [2,7]. Rooijens et al. [8] reported that there were more interventions needed for salvage in patients with prosthetic graft, but patients with poor forearm vessels may do benefit from implantation of a prosthetic graft for vascular access. Therefore, a renewed analysis of native vascular access patency rates is justified. Hemodialysis population characteristics have changed dramatically and primary AVF failure is a significant problem. In prospective, multicenter studies there are standardized definitions to analyze patency rates and risk factors for patency reduction [9].

The aim of this study is to evaluate the successful vascular access rate of arteriovenous fistula, either autogenous AVF or prosthetic graft, in the arm for hemodialysis at a single center.

MATERIALS AND METHODS

Go to

Abstract
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
CONCLUSION
Table
References

1) Patients

Three hundred and sixty two patients who underwent hemodialysis access operation between January 2006 and December 2011 were retrospectively identified. Only the first created AVF per patient in this dataset was used to determine relations between possible risk factors and AVF successful vascular access. Data on age, sex, diabetic status, primary renal disease, and prior tunneled CVC use were analyzed.

2) Definitions

The successful vascular access was defined as a patent fistula vessel at the time of first cannulation of the vascular access for hemodialysis after AVF surgery. When dialysis was known to have taken place through a surgically-created access, the fistula surgery was defined as successful.

A functional AVF is an access that is able to deliver a flow rate of 350?400 mL/min without recirculation for the total duration of dialysis. A nonfunctional AVF is an access that is not being successfully used for hemodialysis whether it is patent or not [10].

Inadequate maturation was defined as insufficient access flow to maintain dialysis or the unavailability to cannulate an AVF, if required, at 6 weeks after surgery. Primary failure (PF) was defined as an AVF that did not develop to maintain dialysis or thrombosed before the first successful cannulation for hemodialysis treatment, regardless of eventual AVF abandonment or not.

3) Statistical analysis

Means are depicted ±standard error of the mean unless otherwise described. The life table method was used to calculate patency rates, and the Fisher’s exact test was used to compare variables differences between both groups. Differences between means of operation site was determined by Pearson’s chi-squared test. Statistical significance was assumed when two-sided P-value was <0.05. Analyses were carried out using PASW Statistics 18.0 (IBM Co., Armonk, NY, USA).

RESULTS

Go to

Abstract
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
CONCLUSION
Table
References

Tables

Go to

Abstract
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
CONCLUSION
Table
References

Clinical characteristics of patients

Clinical characteristic	Value
Total number of patients	362 (100.0)
??Male	211 (58.3)
??Female	151 (41.7)
Age (y)	59.5±14.7
Diabetes mellitus
?? (+)	187 (51.7)
?? (?)	175 (48.3)
Arteriovenous fistula
??Autologous	338 (93.4)
??Graft	24 (6.6)
Operation site
??Wrist (radial a. - cephalic v.)	241 (66.6)
??Cubital (brachial a. - cephalic v./basilic v.)	97 (26.8)
??Graft (brachial a. - brachial v./basilic v.)	15 (4.1)
??Graft (brachial a. - axillary v.)	9 (2.5)
Preoperative central venous catheter
??Insertion	141 (38.9)
??No insertion	217 (61.1)
Other arteriovenous fistula	18 (5.0)
Kidney transplantation	16 (4.4)
Death	31 (8.6)

Risk factors related to successful vascular access rates of arteriovenous fistula

Clinical characteristic	Pass/fail	P-value
Sex		0.290
??Male (n=211)	200/11 (55.2/3.0)
??Female (n=151)	147/4 (40.6/1.1)
Method		0.069
??Autologous (n=338)	326/12 (96.4/3.6)
??Graft (n=24)	21/3 (87.5/12.5)
Operation site		0.498
??Wrist (n=241)	234/7 (64.6/1.9)
??Cubital (n=97)	92/5 (25.4/1.4)
??Graft (brachial a. - brachial/basilic v.) (n=15)	12/3 (3.3/0.8)
??Graft (brachial a. - axillary v.) (n=9)	9/0 (2.5/0.0)
Preoperative central venous catheter		0.012
??Insertion (n=141)	130/11 (35.9/3.1)
??No insertion (n=221)	217/4 (59.9/1.1)
Diabetes mellitus		0.433
??+ (n=187)	181/6 (50.0/1.7)
??? (n=175)	166/9 (45.9/2.4)

References

Go to

Abstract
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
CONCLUSION
Table
References

Hakim, RM, and Himmelfarb, J (2009). Hemodialysis access failure: a call to action--revisited. Kidney Int. 76, 1040-1048.
Collins, AJ, Foley, RN, Herzog, C, Chavers, B, Gilbertson, D, and Ishani, A (2011). US Renal Data System 2010 Annual Data Report. Am J Kidney Dis. 57, Array-526.
, (2001). K/ DOQI Clinical Practice Guidelines for Vascular Access: update 2000. Am J Kidney Dis. 37, S137-S181.
Pisoni, RL, Young, EW, Dykstra, DM, Green wood, RN, Hecking, E, and Gillespie, B (2002). Vascular access use in Europe and the United States: results from the DOPPS. Kidney Int. 61, 305-316.
Allon, M, and Robbin, ML (2002). Increasing arteriovenous fistulas in hemodialysis patients: problems and solutions. Kidney Int. 62, 1109-1124.
Patel, ST, Hughes, J, and Mills, JL (2003). Failure of arteriovenous fistula maturation: an unintended consequence of exceeding dialysis outcome quality Initiative guidelines for hemodialysis access. J Vasc Surg. 38, 439-445.
Murad, MH, Elamin, MB, Sidawy, AN, Malaga, G, Rizvi, AZ, and Flynn, DN (2008). Autogenous versus prosthetic vascular access for hemodialysis: a systematic review and meta-analysis. J Vasc Surg. 48, 34S-47S.
Rooijens, PP, Burgmans, JP, Yo, TI, Hop, WC, de Smet, AA, and van den Dorpel, MA (2005). Autogenous radial-cephalic or prosthetic brachial-antecubital forearm loop AVF in patients with com promised vessels? A randomized, multicenter study of the patency of primary hemodialysis access. J Vasc Surg. 42, 481-486.
Huijbregts, HJ, Bots, ML, Wittens, CH, Schrama, YC, Moll, FL, and Blankestijn, PJ (2008). Hemodialysis arteriovenous fistula patency revisited: results of a prospective, multicenter initiative. Clin J Am Soc Nephrol. 3, 714-719.
Sidawy, AN, Gray, R, Besarab, A, Henry, M, Ascher, E, and Silva, M (2002). Recommended standards for reports dealing with arteriovenous hemo-dialysis accesses. J Vasc Surg. 35, 603-610.
Rooijens, PP, Tordoir, JH, Stijnen, T, Burgmans, JP, Smet de, AA, and Yo, TI (2004). Radiocephalic wrist arteriovenous fistula for hemodialysis: meta-analysis indicates a high primary failure rate. Eur J Vasc Endovasc Surg. 28, 583-589.
Zeebregts, CJ, Tielliu, IF, Hulsebos, RG, de Bruin, C, Verhoeven, EL, and Huisman, RM (2005). Determinants of failure of brachiocephalic elbow fistulas for haemodialysis. Eur J Vasc Endovasc Surg. 30, 209-214.
Suominen, V, Heikkinen, M, Saarinen, J, Zeitlin, R, Wirta, O, and Salenius, J (2003). Primary vascular access surgery in a well defined geographical region: long-term results of autogenous arteriovenous fistulas. Scand J Surg. 92, 210-214.
Monroy-Cuadros, M, Yilmaz, S, Salazar-Ba?uelos, A, and Doig, C (2010). Risk factors associated with patency loss of he mo dialysis vascular access within 6 months. Clin J Am Soc Nephrol. 5, 1787-1792.
Smith, GE, Gohil, R, and Chetter, IC (2012). Factors affecting the patency of arteriovenous fistulas for dialysis access. J Vasc Surg. 55, 849-855.
Lok, CE, Allon, M, Moist, L, Oliver, MJ, Shah, H, and Zimmerman, D (2006). Risk equation determining unsuccessful cannulation events and failure to maturation in arteriovenous fistulas (REDUCE FTM I). J Am Soc Nephrol. 17, 3204-3212.
Thwaites, SE, and Robless, PA (2012). Outcomes of initial hemodialysis access surgery in an Asian population. J Vasc Access. 13, 409-414.
Polkinghorne, KR, McDonald, SP, Atkins, RC, and Kerr, PG (2004). Vascular access and all-cause mortality: a propensity score analysis. J Am Soc Nephrol. 15, 477-486.
Ethier, J, Mendelssohn, DC, Elder, SJ, Hasegawa, T, Akizawa, T, and Akiba, T (2008). Vascular access use and outcomes: an international perspective from the dialysis outcomes and practice patterns study. Nephrol Dial Trans plant. 23, 3219-3226.
Huijbregts, HJ, Bots, ML, Moll, FL, and Blankestijn, PJ (2007). Hospital specific aspects predominantly determine primary failure of hemodialysis arteriovenous fistulas. J Vasc Surg. 45, 962-967.
Malovrh, M (2002). Native arteriovenous fistula: preoperative evaluation. Am J Kidney Dis. 39, 1218-1225.
Konner, K (2002). The anastomosis of the arteriovenous fistula--common errors and their avoidance. Nephrol Dial Transplant. 17, 376-379.
Jennings, WC (2006). Creating arteriovenous fistulas in 132 consecutive patients: exploiting the proximal radial artery arteriovenous fistula: reliable, safe, and simple forearm and upper arm hemodialysis access. Arch Surg. 141, 27-32.
Bonforte, G, Zerbi, S, and Surian, M (2004). The middle-arm fistula: a new native arteriovenous vascular access for hemodialysis patients. Ann Vasc Surg. 18, 448-452.
Beathard, GA, Arnold, P, Jackson, J, and Litchfield, T (2003). Aggressive treatment of early fistula failure. Kidney Int. 64, 1487-1494.
Turmel-Rodrigues, L, Mouton, A, Birmel?, B, Billaux, L, Ammar, N, and Gr?zard, O (2001). Salvage of immature forearm fistulas for haemodialysis by interventional radiology. Nephrol Dial Transplant. 16, 2365-2371.

Article

Original Article

Vascular Specialist International 2014; 30(1): 33-37

Published online March 30, 2014 https://doi.org/10.5758/vsi.2014.30.1.33

Successful Access Rate and Risk Factor of Vascular Access Surgery in Arm for Dialysis

Dae Woo Yoo¹, Myunghee Yoon², and Hee Jae Jun³

¹Department of Surgery, BHS Hanseo Hospital, Busan, ²Department of Surgery, Kosin University Gospel Hospital, Busan, ³Department of Thoracic and Cardiovascular Surgery, Inje University Haeundae Paik Hospital, Busan, Korea

Correspondence to:Hee Jae Jun Department of Thoracic and Cardio vascular Surgery, Haeundae Paik Hospital, Inje University, 875 Haeun-daero, Haeundae-gu, Busan 612-896, Korea, Tel: 82-51-797-3131, Fax: 82-51-797-3101, E-mail: cs523@dreamwiz.com

Received: January 3, 2014; Accepted: February 19, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

Preservation of adequate vascular access is of vital importance for patients undergoing chronic dialysis in renal failure. The aim of this study is to evaluate the successful access rate and risk factors of arteriovenous fistula (AVF) in the arm for dialysis at a single center.

Materials and Methods:

Patients undergoing vascular access operation between January 2006 and December 2011 were retrospectively identified.

Results:

A total of 362 vascular access operations were performed. There were 338 autologous AVFs (93.4%) and 24 prosthetic grafts (6.6%). Men comprised 58.3% of all subjects. Mean age was 59.5±14.7 years. There were 187 diabetes mellitus patients (51.7%). There was a mean duration of 70.3±21.1 days between access creation to first cannulation. Overall successful access rate for dialysis was 95.9%. Of 338 autologous AVFs, 326 patients had patent AVFs for dialysis (96.4% surgical success rate), while 21 of 24 prosthetic grafts were patent (87.5% surgical success rate). A total of 141 patients (38.9%) came to surgery with preoperative central venous catheters (CVC) of which 130 (35.9%) AVFs had a patent fistula in the arm. The only risk factor related to successful access rate of AVF was preoperative CVC placement (P=0.012).

Conclusion:

Successful vascular access rate was 95.9%. The only risk factor related to patent access of AVF was preoperative CVC placement. At least 6 months prior to expected dialysis, AVF surgery is recommended, which may overcome the challenge of co-morbid conditions from having a preoperative CVC.

Keywords: Arteriovenous fistula, Patency, Renal insufficiency

INTRODUCTION

The incidence of dialysis-dependent end stage renal failure is increasing. Preservation of adequate vascular access is of vital importance for patients undergoing chronic dialysis in end stage renal disease. Unfortunately, access-related morbidity adds significantly to total annual expenditure on the hemodialysis population and is associated with a poorer long-term prognosis [1,2]. The goal of the dialysis surgeon, therefore, is to create a permanent access which is both effective and durable. The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) standards promote the increase of native vascular access use because of superior patency rates and lower complication rates than grafts once established [3]. However, current hemodialysis patients are older, more often have diabetes and more often have cardiovascular comorbidities [2?4]. Moreover, arteriovenous fistulas (AVF) have high primary failure rates and maturation problems will increasingly challenge vascular access teams in meeting the KDOQI goals [5,6]. Fistula dialysis patients have fewer complications, require a shorter hospital stay and have better overall survival rate than those who dialyze with a tunneled central venous catheter (CVC) or prosthetic graft [2,7]. Rooijens et al. [8] reported that there were more interventions needed for salvage in patients with prosthetic graft, but patients with poor forearm vessels may do benefit from implantation of a prosthetic graft for vascular access. Therefore, a renewed analysis of native vascular access patency rates is justified. Hemodialysis population characteristics have changed dramatically and primary AVF failure is a significant problem. In prospective, multicenter studies there are standardized definitions to analyze patency rates and risk factors for patency reduction [9].

The aim of this study is to evaluate the successful vascular access rate of arteriovenous fistula, either autogenous AVF or prosthetic graft, in the arm for hemodialysis at a single center.

MATERIALS AND METHODS

1) Patients

Three hundred and sixty two patients who underwent hemodialysis access operation between January 2006 and December 2011 were retrospectively identified. Only the first created AVF per patient in this dataset was used to determine relations between possible risk factors and AVF successful vascular access. Data on age, sex, diabetic status, primary renal disease, and prior tunneled CVC use were analyzed.

2) Definitions

The successful vascular access was defined as a patent fistula vessel at the time of first cannulation of the vascular access for hemodialysis after AVF surgery. When dialysis was known to have taken place through a surgically-created access, the fistula surgery was defined as successful.

A functional AVF is an access that is able to deliver a flow rate of 350?400 mL/min without recirculation for the total duration of dialysis. A nonfunctional AVF is an access that is not being successfully used for hemodialysis whether it is patent or not [10].

Inadequate maturation was defined as insufficient access flow to maintain dialysis or the unavailability to cannulate an AVF, if required, at 6 weeks after surgery. Primary failure (PF) was defined as an AVF that did not develop to maintain dialysis or thrombosed before the first successful cannulation for hemodialysis treatment, regardless of eventual AVF abandonment or not.

3) Statistical analysis

Means are depicted ±standard error of the mean unless otherwise described. The life table method was used to calculate patency rates, and the Fisher’s exact test was used to compare variables differences between both groups. Differences between means of operation site was determined by Pearson’s chi-squared test. Statistical significance was assumed when two-sided P-value was <0.05. Analyses were carried out using PASW Statistics 18.0 (IBM Co., Armonk, NY, USA).

Clinical characteristics of patients.

Clinical characteristic	Value
Total number of patients	362 (100.0)
??Male	211 (58.3)
??Female	151 (41.7)
Age (y)	59.5±14.7
Diabetes mellitus
?? (+)	187 (51.7)
?? (?)	175 (48.3)
Arteriovenous fistula
??Autologous	338 (93.4)
??Graft	24 (6.6)
Operation site
??Wrist (radial a. - cephalic v.)	241 (66.6)
??Cubital (brachial a. - cephalic v./basilic v.)	97 (26.8)
??Graft (brachial a. - brachial v./basilic v.)	15 (4.1)
??Graft (brachial a. - axillary v.)	9 (2.5)
Preoperative central venous catheter
??Insertion	141 (38.9)
??No insertion	217 (61.1)
Other arteriovenous fistula	18 (5.0)
Kidney transplantation	16 (4.4)
Death	31 (8.6)

Values are presented as number (%) or mean±standard deviation..

a., artery; v., vein..

Risk factors related to successful vascular access rates of arteriovenous fistula.

Clinical characteristic	Pass/fail	P-value
Sex		0.290
??Male (n=211)	200/11 (55.2/3.0)
??Female (n=151)	147/4 (40.6/1.1)
Method		0.069
??Autologous (n=338)	326/12 (96.4/3.6)
??Graft (n=24)	21/3 (87.5/12.5)
Operation site		0.498
??Wrist (n=241)	234/7 (64.6/1.9)
??Cubital (n=97)	92/5 (25.4/1.4)
??Graft (brachial a. - brachial/basilic v.) (n=15)	12/3 (3.3/0.8)
??Graft (brachial a. - axillary v.) (n=9)	9/0 (2.5/0.0)
Preoperative central venous catheter		0.012
??Insertion (n=141)	130/11 (35.9/3.1)
??No insertion (n=221)	217/4 (59.9/1.1)
Diabetes mellitus		0.433
??+ (n=187)	181/6 (50.0/1.7)
??? (n=175)	166/9 (45.9/2.4)

Values are presented as number (%)..

a., artery; v., vein..

References

Hakim, RM, and Himmelfarb, J (2009). Hemodialysis access failure: a call to action--revisited. Kidney Int. 76, 1040-1048.
Collins, AJ, Foley, RN, Herzog, C, Chavers, B, Gilbertson, D, and Ishani, A (2011). US Renal Data System 2010 Annual Data Report. Am J Kidney Dis. 57, Array-526.
, (2001). K/ DOQI Clinical Practice Guidelines for Vascular Access: update 2000. Am J Kidney Dis. 37, S137-S181.
Pisoni, RL, Young, EW, Dykstra, DM, Green wood, RN, Hecking, E, and Gillespie, B (2002). Vascular access use in Europe and the United States: results from the DOPPS. Kidney Int. 61, 305-316.
Allon, M, and Robbin, ML (2002). Increasing arteriovenous fistulas in hemodialysis patients: problems and solutions. Kidney Int. 62, 1109-1124.
Patel, ST, Hughes, J, and Mills, JL (2003). Failure of arteriovenous fistula maturation: an unintended consequence of exceeding dialysis outcome quality Initiative guidelines for hemodialysis access. J Vasc Surg. 38, 439-445.
Murad, MH, Elamin, MB, Sidawy, AN, Malaga, G, Rizvi, AZ, and Flynn, DN (2008). Autogenous versus prosthetic vascular access for hemodialysis: a systematic review and meta-analysis. J Vasc Surg. 48, 34S-47S.
Rooijens, PP, Burgmans, JP, Yo, TI, Hop, WC, de Smet, AA, and van den Dorpel, MA (2005). Autogenous radial-cephalic or prosthetic brachial-antecubital forearm loop AVF in patients with com promised vessels? A randomized, multicenter study of the patency of primary hemodialysis access. J Vasc Surg. 42, 481-486.
Huijbregts, HJ, Bots, ML, Wittens, CH, Schrama, YC, Moll, FL, and Blankestijn, PJ (2008). Hemodialysis arteriovenous fistula patency revisited: results of a prospective, multicenter initiative. Clin J Am Soc Nephrol. 3, 714-719.
Sidawy, AN, Gray, R, Besarab, A, Henry, M, Ascher, E, and Silva, M (2002). Recommended standards for reports dealing with arteriovenous hemo-dialysis accesses. J Vasc Surg. 35, 603-610.
Rooijens, PP, Tordoir, JH, Stijnen, T, Burgmans, JP, Smet de, AA, and Yo, TI (2004). Radiocephalic wrist arteriovenous fistula for hemodialysis: meta-analysis indicates a high primary failure rate. Eur J Vasc Endovasc Surg. 28, 583-589.
Zeebregts, CJ, Tielliu, IF, Hulsebos, RG, de Bruin, C, Verhoeven, EL, and Huisman, RM (2005). Determinants of failure of brachiocephalic elbow fistulas for haemodialysis. Eur J Vasc Endovasc Surg. 30, 209-214.
Suominen, V, Heikkinen, M, Saarinen, J, Zeitlin, R, Wirta, O, and Salenius, J (2003). Primary vascular access surgery in a well defined geographical region: long-term results of autogenous arteriovenous fistulas. Scand J Surg. 92, 210-214.
Monroy-Cuadros, M, Yilmaz, S, Salazar-Ba?uelos, A, and Doig, C (2010). Risk factors associated with patency loss of he mo dialysis vascular access within 6 months. Clin J Am Soc Nephrol. 5, 1787-1792.
Smith, GE, Gohil, R, and Chetter, IC (2012). Factors affecting the patency of arteriovenous fistulas for dialysis access. J Vasc Surg. 55, 849-855.
Lok, CE, Allon, M, Moist, L, Oliver, MJ, Shah, H, and Zimmerman, D (2006). Risk equation determining unsuccessful cannulation events and failure to maturation in arteriovenous fistulas (REDUCE FTM I). J Am Soc Nephrol. 17, 3204-3212.
Thwaites, SE, and Robless, PA (2012). Outcomes of initial hemodialysis access surgery in an Asian population. J Vasc Access. 13, 409-414.
Polkinghorne, KR, McDonald, SP, Atkins, RC, and Kerr, PG (2004). Vascular access and all-cause mortality: a propensity score analysis. J Am Soc Nephrol. 15, 477-486.
Ethier, J, Mendelssohn, DC, Elder, SJ, Hasegawa, T, Akizawa, T, and Akiba, T (2008). Vascular access use and outcomes: an international perspective from the dialysis outcomes and practice patterns study. Nephrol Dial Trans plant. 23, 3219-3226.
Huijbregts, HJ, Bots, ML, Moll, FL, and Blankestijn, PJ (2007). Hospital specific aspects predominantly determine primary failure of hemodialysis arteriovenous fistulas. J Vasc Surg. 45, 962-967.
Malovrh, M (2002). Native arteriovenous fistula: preoperative evaluation. Am J Kidney Dis. 39, 1218-1225.
Konner, K (2002). The anastomosis of the arteriovenous fistula--common errors and their avoidance. Nephrol Dial Transplant. 17, 376-379.
Jennings, WC (2006). Creating arteriovenous fistulas in 132 consecutive patients: exploiting the proximal radial artery arteriovenous fistula: reliable, safe, and simple forearm and upper arm hemodialysis access. Arch Surg. 141, 27-32.
Bonforte, G, Zerbi, S, and Surian, M (2004). The middle-arm fistula: a new native arteriovenous vascular access for hemodialysis patients. Ann Vasc Surg. 18, 448-452.
Beathard, GA, Arnold, P, Jackson, J, and Litchfield, T (2003). Aggressive treatment of early fistula failure. Kidney Int. 64, 1487-1494.
Turmel-Rodrigues, L, Mouton, A, Birmel?, B, Billaux, L, Ammar, N, and Gr?zard, O (2001). Salvage of immature forearm fistulas for haemodialysis by interventional radiology. Nephrol Dial Transplant. 16, 2365-2371.

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Original Article