Predictors of Mortality within 24 Months of Initial Arteriovenous Access Creation

2021 ◽  
Author(s):  
Patrick Sowa ◽  
Matthew Blecha
Keyword(s):  
Predictors Of Mortality ◽  
Arteriovenous Access

A single-centre, retrospective analysis of mortality over 80 months comparing paclitaxel-coated balloon versus standard balloon angioplasty in the treatment of dysfunctional arteriovenous access

2021 ◽  
pp. 112972982110667
Author(s):  
Alexandra M Riding ◽  
Ahmed Al-Nowfal ◽  
Siva Ramanarayanan ◽  
Oscar Swift ◽  
Suresh Mathavakkannan ◽  
...  
Keyword(s):  
Balloon Angioplasty ◽  
Neointimal Hyperplasia ◽  
Transluminal Angioplasty ◽  
Single Centre ◽  
Dialysis Adequacy ◽  
Predictors Of Mortality ◽  
Co Morbidity ◽  
Arteriovenous Access ◽  
Comorbidity Index

Aim: Percutaneous transluminal angioplasty (PTA) is a standard treatment for arteriovenous fistula (AVF) stenosis to preserve haemodialysis vascular access, promoting improved dialysis adequacy and better outcomes for those dependent on renal replacement therapy. Drug coated balloons (DCB) may help reduce the rate of neointimal hyperplasia and recurrent stenosis, but their use in femoropopliteal angioplasty has been associated with increased mortality at 2 and 5 year follow-up. This study aims to address the long-term safety of PTA for AVF stenosis with clinical correlation to participant co-morbidity and mortality. Methods: All patients undergoing PTA for AVF stenosis at a single centre between 2013 and 2017 were identified and grouped according to the use of DCB versus standard balloon angioplasty. All data was anonymised and correlated to verify independent predictors of mortality. Results: 481 (400 standard balloon; 81 DCB) procedures were performed in 313 patients (250 standard balloon; 63 DCB). Follow-up at 80 months did not show any difference in mortality ( p = 0.546). Multivariate analysis identified time on dialysis ( p < 0.001), age ( p = 0.001) and Charlson comorbidity index ( p = 0.02) as independent predictors of mortality. Conclusions: In this study, mortality was not associated with the use of DCBs, but was related to established factors of dialysis longevity, age and comorbidity.

Prosthesis-Patient Mismatch Causes a Significantly Increased Risk of Operative Mortality in Aortic Valve Replacement

2014 ◽  
Vol 17 (3) ◽  
pp. 127 ◽  
Author(s):  
Muhammad Shahzeb Khan ◽  
Faizan Imran Bawany ◽  
Asadullah Khan ◽  
Mehwish Hussain
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Operative Mortality ◽  
Univariate Analysis ◽  
Female Gender ◽  
Valve Prosthesis ◽  
Predictors Of Mortality ◽  
Increased Risk ◽  
Urgent Operation

<p><b>Background:</b> Small aortic prosthesis can lead to prosthesis-patient mismatch (PPM). Implanting such small prosthesis remains a controversial issue. This study was done to investigate whether or not PPM causes an increased operative mortality in aortic valve replacement (AVR).</p><p><b>Methods:</b> Two-hundred-two consecutive patients undergoing primary AVR in a tertiary hospital were included. The sample was grouped according to the aortic valve prosthesis size: ?21 mm (small) and >21 mm (standard). The effect of variables on outcomes was determined by univariate and multivariable regression analyses.</p><p><b>Results:</b> PPM was found significantly more among patients with AVR ? 21mm (<i>P</i> < 0.0001). Moreover, the likelihood of mortality also was significantly higher in these patients (<i>P</i> < 0.0001). Univariate analysis demonstrated small prosthesis size, urgent operation, PPM, female gender, and NYHA Class IV as significant predictors of mortality. Multivariate regression identified female gender, PPM, and urgent operation as the key independent predictors of mortality.</p><p><b>Conclusion:</b> PPM and female gender are significant predictors of mortality. Care should be taken to prevent PPM by implanting larger prosthesis especially in females.</p>

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