Abstract

FERREIRA, Ana; SAMPAIO, Sérgio; CERQUEIRA, Alfredo  and  TEIXEIRA, José. Autologous angioaccess: Determinants of functionality and patency. Angiol Cir Vasc [online]. 2013, vol.9, n.2, pp.46-51. ISSN 1646-706X.

Objective: Identification and quantification of impact permeability and funcionality's determinants in hemodyalisis access. Materials and methods: We analyzed retrospectively data from 94 autologous access for hemodialysis performed in 88 patients in 2010. The permeability and functionality rates were estimated by the Kaplan-Meier method. Impact of potential determinants was assessed by the log rank test (categorical variables) and by Cox regression (continuous variables). Results: The mean age was 68 years (28-89) and there were 39 (44%) women and 49 (56%) men. Fifty-one (53.3%) fistulas were wrist located, 8 (8.5%) in the forearm and 19 (37.2%) in the elbow. Primary permeability rates were 75% at 6 months, 74% at 12 months and remained in the final observation, at 780 days. All patients who started dialysis maintained functionality in the last observation. Twenty-four patients were reintervencionated: 4 balloon angioplasty, 18 built a new access and two closures for steal syndrome. At 898 days the mortality rate was 4.5%. None of samples variables had a significant relationship in the early or late occlusion of access although the existence of an occluded anterior fistula had p value close to statistical significance (p = 0.200). Conclusion: Most accesses are constructed according to the latest recommendations of the National Kidney Foundation-Kidney Dialysis Outcomes Quality Initiative (NKF-KDOQI), mostly located in the wrist, with patency rates and primary functionality overlapping the literature. The primary failure was noted in early periods of follow-up followed by the stabilization of permeability curves.

Keywords : Arteriovenous fistula; Vascular patency; Vascular funcionality; Risk factor.

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