دورية أكاديمية
Sentinel Vascular Access Monitoring After Endovascular Intervention Predicts Access Outcome
| العنوان: | Sentinel Vascular Access Monitoring After Endovascular Intervention Predicts Access Outcome |
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| المؤلفون: | Kumbar, Lalathaksha, Peterson, Edward L, Zaborowicz, Matthew, Besarab, Anatole, Yee, Jerry, Zasuwa, Gerard |
| المصدر: | Nephrology Articles |
| بيانات النشر: | Henry Ford Health Scholarly Commons |
| سنة النشر: | 2019 |
| المجموعة: | Henry Ford Health System Scholarly Commons |
| مصطلحات موضوعية: | Aged, Algorithms, Angioplasty, Balloon, Arterial Pressure, Arteriovenous Shunt, Surgical, Blood Pressure Determination, Blood Vessel Prosthesis Implantation, Female, Graft Occlusion, Vascular, Humans, Kidney Failure, Chronic, Male, Middle Aged, Predictive Value of Tests, Renal Dialysis, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Vascular Patency, Venous Pressure |
| الوصف: | BACKGROUND AND OBJECTIVES: The vascular access pressure ratio test identifies dialysis vascular access dysfunction when three consecutive vascular access pressure ratios are >0.55. We tested whether the magnitude of the decline in vascular access pressure ratio 1-week post-intervention could alert of subsequent access failure. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: The retrospective study included all vascular access procedures at one institution from March 2014 to June 2016. Data included demographics, comorbidities, vascular access features, %ΔVAPR = ((Pre-Post)/Pre] × 100% assessed within the first 2 weeks post-percutaneous transluminal balloon angioplasty, time-to-next procedure, and patency. The log-rank test compared the area under the curve, receiver operating curve, Kaplan-Meier arteriovenous graft and arteriovenous fistula survival curves. A multivariable Cox proportional hazard (CP) model was used to determine the association of %ΔVAPR with access patency. RESULTS: Analysis of 138 subjects (females 51%; Black 87%) included 64 arteriovenous fistulas with 104 angioplasties and 74 arteriovenous grafts with 134 angioplasties. The area under the receiver operating characteristic curve for fistula failure at 3 months was 0.59, with optimal screening characteristics of 33.3%, sensitivity of 56.1%, and specificity of 63.2%. Arteriovenous fistula with33.3% required earlier subsequent procedure (136 vs 231 days), lower survival on Kaplan-Meier analysis (P = 0.01), and twofold greater risk of failure (P = .006). Area under the receiver operating characteristic for arteriovenous graft failure at 3 months had a sensitivity of 52.3% and specificity of 67.4%. Arteriovenous graft with a post-intervention vascular access pressure ratio decline of CONCLUSION: The magnitude of post-intervention reduction in vascular access pressure ratio provides a novel predictive measure of access outcomes. |
| نوع الوثيقة: | text |
| وصف الملف: | application/pdf |
| اللغة: | unknown |
| العلاقة: | https://scholarlycommons.henryford.com/nephrology_articles/132Test; https://scholarlycommons.henryford.com/context/nephrology_articles/article/1130/viewcontent/1129729818812729.pdfTest |
| الإتاحة: | https://scholarlycommons.henryford.com/nephrology_articles/132Test https://scholarlycommons.henryford.com/context/nephrology_articles/article/1130/viewcontent/1129729818812729.pdfTest |
| رقم الانضمام: | edsbas.FF88E791 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |