scholarly journals Morphological Lesion Types Are Associated with Primary and Secondary Patency Rates after High-Pressure Balloon Angioplasty for Dysfunctional Arteriovenous Fistulas

2021 ◽  
pp. 1-10
Author(s):  
Li Chen ◽  
Weichen Zhang ◽  
Jinyun Tan ◽  
Min Hu ◽  
Weihao Shi ◽  
...  
Keyword(s):  
Patency Rate ◽  
Cox Regression ◽  
Neointimal Hyperplasia ◽  
Primary Patency ◽  
Secondary Patency ◽  
Type I ◽  
Type Ii ◽  
Cox Regression Analysis ◽  
Type Iii ◽  
Kaplan Meier

<b><i>Background:</i></b> Neointimal hyperplasia (NIH) is believed to be the main reason for arteriovenous fistula (AVF) dysfunction, but other mechanisms are also recognized to be involved in the pathophysiological process. This study investigated whether different morphological types of AVF lesions are associated with the patency rate after percutaneous transluminal angioplasty (PTA). <b><i>Methods:</i></b> This retrospective study included 120 patients who underwent PTA for autogenous AVF dysfunction. All the cases were evaluated under Doppler ultrasound (DU) before intervention and divided into 3 types: Type I (NIH type), Type II (non-NIH type), and Type III (mixed type). Prognostic and clinical data were analyzed by Kaplan-Meier analysis and the Cox proportional hazards model. <b><i>Results:</i></b> There was no statistical difference in baseline variables among groups, except for lumen diameter. The primary patency rates in Type I, Type II, and Type III groups were 78.4, 93.2, and 83.2% at 6 months and 59.5, 84.7, and 75.5% at 1 year, respectively. The secondary patency rates in Type I, Type II, and Type III groups were 94.4, 97.1, and 100% at 6 months and 90.5, 97.1, and 94.7% at 1 year, respectively. The Kaplan-Meier curve showed that the primary and secondary patency rates of Type I group were lower than those of Type II group. Multivariable Cox regression analysis demonstrated that postoperative primary patency was correlated with end-to-end anastomosis (hazard ratio [HR] = 2.997, <i>p</i> = 0.008, 95% confidence interval [CI]: 1.328–6.764) and Type I lesion (HR = 5.395, <i>p</i> = 0.004, 95% CI: 1.730–16.824). <b><i>Conclusions:</i></b> NIH-dominant lesions of AVF evaluated by DU preoperatively were a risk factor for poor primary and secondary patency rate after PTA in hemodialysis patients.

Infrainguinal Atherectomy Using the Transluminal Endarterectomy Catheter: Patency Rates and Clinical Success for 144 Procedures

1994 ◽  
Vol 1 (1) ◽  
pp. 61-70 ◽  
Author(s):  
Kenneth A. Myers ◽  
Michael J. Denton ◽  
Terence J. Devine
Keyword(s):  
Patency Rate ◽  
Cox Regression ◽  
Clinical Success ◽  
Balloon Dilation ◽  
Primary Patency ◽  
Secondary Patency ◽  
Open Approach ◽  
Primary Patency Rate ◽  
Critical Ischemia ◽  
Cox Regression Analysis

Purpose: To determine if atherectomy using the transluminal endarterectomy catheter (TEC) is an effective endoluminal therapy for infrainguinal occlusive disease. Methods: Three surgeons used the TEC for 144 infrainguinal atherectomy procedures in 133 patients. The indications were severe claudication in 83, critical ischemia in 56, and graft stenosis in 5 limbs. The pathology was stenosis in 36 and occlusion in 105 limbs. Balloon dilation was also performed in 109 and stenting in 17 limbs. Results: There was initial technical and anatomic success in 124 (86%) procedures. There were 67 technically successful procedures at mean follow-up of 19 months, although 3 of these limbs with gangrene and extensive distal disease required major amputation. There were 26 failures due to stenosis leading to further intervention and 51 due to occlusion. Twenty of these cases were managed conservatively, 21 were treated with repeat endovascular intervention, 31 with bypass grafting, and 5 with amputation. Repeat intervention in 52 limbs resulted in 36 with patent arteries, 10that are occluded, and 6that required amputation. Thirteen of the 14 amputations were for limbs with critical ischemia, but 1 was in a patient with claudication. Life-table analysis showed that the primary patency rate was 51%, the assisted primary patency rate was 61%, and the secondary patency rate was 75% at 15 months. The clinical success rate was 49%, and the salvage rate for limbs with critical ischemia was 78% at 12 months. Univariate log-rank testing showed no significant differences according to the clinical presentation or pathology, but results were worse for lesions > 5 cm long due to more frequent immediate failures. However, multivariate Cox regression analysis showed that results were significantly worse for critical ischemia than for claudication, stenosis compared to occlusions, for limbs with poor runoff, for operations performed by percutaneous rather than an open approach, and for those performed more recently. Conclusions: TEC atherectomy may have a place in selected patients, but the optimal circumstances for its use and long-term efficacy require further study.

scholarly journals One-year outcomes of drug-coated balloon treatment for long femoropopliteal lesions: a multicentre cohort and real-world study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoxi Yu ◽  
Xin Zhang ◽  
Zhichao Lai ◽  
Jiang Shao ◽  
Rong Zeng ◽  
...  
Keyword(s):  
Real World ◽  
Cox Regression ◽  
Ankle Brachial Index ◽  
Primary Patency ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Cox Regression Analysis ◽  
Femoropopliteal Artery ◽  
Kaplan Meier ◽  
Multicentre Cohort

Abstract Background Drug-coated balloons (DCBs) have shown superiority in the endovascular treatment of short femoropopliteal artery disease. Few studies have focused on outcomes in long lesions. This study aimed to evaluate the safety and effectiveness of Orchid® DCBs in long lesions over 1 year of follow-up. Methods This study is a multicentre cohort and real-world study. The patients had lesions longer than or equal to 150 mm of the femoropopliteal artery and were revascularized with DCBs. The primary endpoints were primary patency, freedom from clinically driven target lesion revascularization (TLR) at 12 months and major adverse events (all-cause death and major target limb amputation). The secondary endpoints were the changes in Rutherford classification and the ankle brachial index (ABI). Results One hundred fifteen lesions in 109 patients (mean age 67 ± 11 years, male proportion 71.6%) were included in this study. The mean lesion length was 252.3 ± 55.4 mm, and 78.3% of the lesions were chronic total occlusion (CTO). Primary patency by Kaplan–Meier estimation was 98.1% at 6 months and 82.1% at 12 months. The rate of freedom from TLR by Kaplan–Meier estimation was 88.4% through 12 months. There were no procedure- or device-related deaths through 12 months. The rate of all-cause death was 2.8%. Cox regression analysis suggested that renal failure and critical limb ischaemia (CLI) were statistically significant predictors of the primary patency endpoint. Conclusion In our real-world study, DCBs were safe and effective when used in long femoropopliteal lesions, and the primary patency rate at 12 months by Kaplan–Meier estimation was 82.1%.

Type I Versus Type II Endometrial Cancer: Differential Impact of Comorbidity

2018 ◽  
Vol 28 (3) ◽  
pp. 586-593 ◽  
Author(s):  
Mette Calundann Noer ◽  
Sofie Leisby Antonsen ◽  
Bent Ottesen ◽  
Ib Jarle Christensen ◽  
Claus Høgdall
Keyword(s):  
Cox Regression ◽  
Type I ◽  
Prognostic Impact ◽  
Type Ii ◽  
Regression Analyses ◽  
Differential Impact ◽  
Kaplan Meier ◽  
Prediction Of Survival ◽  
Comorbidity Index ◽  
The Impact

ObjectiveTwo distinct types of endometrial carcinoma (EC) with different etiology, tumor characteristics, and prognosis are recognized. We investigated if the prognostic impact of comorbidity varies between these 2 types of EC. Furthermore, we studied if the recently developed ovarian cancer comorbidity index (OCCI) is useful for prediction of survival in EC.Materials and MethodsThis nationwide register-based cohort study was based on data from 6487 EC patients diagnosed in Denmark between 2005 and 2015. Patients were assigned a comorbidity index score according to the Charlson comorbidity index (CCI) and the OCCI. Kaplan-Meier survival statistics and adjusted multivariate Cox regression analyses were used to investigate the differential association between comorbidity and overall survival in types I and II EC.ResultsThe distribution of comorbidities varied between the 2 EC types. A consistent association between increasing levels of comorbidity and poorer survival was observed for both types. Cox regression analyses revealed a significant interaction between cancer stage and comorbidity indicating that the impact of comorbidity varied with stage. In contrast, the interaction between comorbidity and EC type was not significant. Both the CCI and the OCCI were useful measurements of comorbidity, but the CCI was the strongest predictor in this patient population.ConclusionsComorbidity is an important prognostic factor in type I as well as in type II EC although the overall prognosis differs significantly between the 2 types of EC. The prognostic impact of comorbidity varies with stage but not with type of EC.

Outcomes From the Multicenter Italian Registry on Primary Endovascular Treatment of Aortoiliac Occlusive Disease

2019 ◽  
Vol 26 (5) ◽  
pp. 623-632 ◽  
Author(s):  
Gabriele Piffaretti ◽  
Aaron Thomas Fargion ◽  
Walter Dorigo ◽  
Raffaele Pulli ◽  
Andrea Gattuso ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cox Regression ◽  
Limb Ischemia ◽  
Primary Patency ◽  
Occlusive Disease ◽  
Endovascular Intervention ◽  
Chronic Obstructive ◽  
Secondary Patency ◽  
Aortoiliac Occlusive Disease ◽  
Cox Regression Analysis

Purpose: To report the results of endovascular treatment of iliac and complex aortoiliac occlusive disease (AIOD) in a multicenter Italian registry. Materials and Methods: A retrospective, multicenter, observational cohort study analyzed 713 patients (mean age 68±10 years; 539 men) with isolated iliac and complex aortoiliac lesions treated with primary stenting between January 2015 and December 2017. Indications for treatment were claudication in 406 (57%) patients and critical limb ischemia in 307 (43%). According to the TransAtlantic Inter-Society Consensus II (TASC) classification, the lesions were categorized as type A (104, 15%), type B (171, 24%), type C (170, 24%), and type D (268, 37%). Early (<30 days) endpoints included mortality, thrombosis, and major complications. Late major outcomes were primary and secondary patency and freedom from reintervention as estimated by Kaplan-Meier analysis; estimates are given with the 95% confidence intervals (CIs). Associations between baseline variables and primary patency were sought with multivariate analysis; the results are presented as the hazard ratio (HR) and 95% CI. Results: Technical success was achieved in 708 (99%) lesions; in-hospital mortality was 0.6% (n=4). The median follow-up was 11 months (range 0–42). The estimated primary patency rate was 96% (95% CI 94% to 97%) at 1 year and 94% (95% CI 91% to 96%) at 2 years. The estimated secondary patency was 99% (95% CI 97% to 99%) at 1 year and 98% (95% CI 95% to 99%) at 2 years. The estimated freedom from reintervention was 98% (95% CI 96% to 99%) at 1 year and 97% (95% CI 94% to 98.5%) at 2 years. Cox regression analysis demonstrated that the application of a covered stent was associated with an increased need for reintervention (HR 1.4, 95% CI 1.10 to 1.74, p=0.005). Chronic obstructive pulmonary disease was associated with decreased primary patency (HR 3.7, 95% CI 1.25 to 10.8, p=0.018). Conclusion: Endovascular intervention with primary stent placement for aortoiliac occlusive disease achieved satisfactory 2-year patency regardless of the complexity of the lesion. Almost all TASC lesions should be considered for primary endovascular intervention if suitable.

Is fetuin-A a biomarker of dialysis access dysfunction?

2021 ◽  
pp. 112972982110358
Author(s):  
Ramon Roca-Tey ◽  
Manel Ramírez de Arellano ◽  
Juan Carlos González-Oliva ◽  
Amparo Roda ◽  
Rosa Samon ◽  
...  
Keyword(s):  
Cox Regression ◽  
Neointimal Hyperplasia ◽  
Hazard Ratio ◽  
Rank Test ◽  
Dialysis Access ◽  
Baseline Serum ◽  
Fetuin A ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Artery Stiffness

Background: The arteriovenous (AV) access function of hemodialysis (HD) patients can be impaired by afferent artery stiffness due to preexisting microcalcification and by venous stenosis secondary to neointimal hyperplasia in whose development participates an upregulated local inflammatory process. Fetuin-A is a circulating potent inhibitor of vascular calcification and plays an important anti-inflammatory role. The aims of this prospective study were to investigate the relationship between baseline serum fetuin-A levels and: blood flow (QA) values at baseline, AV access failure (thrombosis or intervention for stenosis) during follow-up and primary unassisted AV access patency. Methods: We measured baseline serum fetuin-A levels and QA values of the AV access in 64 HD patients under routine QA surveillance for stenosis. Patients were classified into tertiles according to their baseline fetuin-A levels (g/L): <0.5 (tertile-1), 0.5–1.20 (tertile-2), and >1.20 (tertile-3). Results: Fetuin-A was positively correlated with QA (Spearman coefficient = 0.311, p = 0.012). Fourteen patients (21.9%) underwent AV access failure and they had lower fetuin-A (0.59 ± 0.32 g/L) and lower QA (739.4 ± 438.8 mL/min) values at baseline compared with the remaining patients (1.05 ± 0.65 g/L and 1273.0 ± 596.3 mL/min, respectively) ( p = 0.027 and p < 0.001, respectively). The AV access failure rate was highest (34.8%) in tertile-1 (lowest fetuin-A level). Unadjusted Cox regression analysis showed a decrease in the risk of AV access patency loss by increasing fetuin-A concentration (hazard ratio 0.395 (95% confidence interval: 1.42–1.69), p = 0.044) but it was not confirmed in the adjusted model, although the hazard ratio was low (0.523). Kaplan–Meier analysis showed that patients in tertile-3 (highest fetuin-A concentration) had the highest primary unassisted AV access patency (λ2 = 4.68, p = 0.030, log-rank test). Conclusion: If our results are confirmed in further studies, fetuin-A could be used as a circulating biomarker to identify HD patients at greater risk for AV access dysfunction, who would benefit from much closer dialysis access surveillance.

scholarly journals Long-term outcomes of thigh arteriovenous graft stenting

2021 ◽  
Vol 9 (3) ◽  
pp. 71-77
Author(s):  
Masa Abaza BS ◽  
Sloan E Almehmi ◽  
Alian AlBalas ◽  
Ammar Almehmi
Keyword(s):  
Patency Rate ◽  
Primary Patency ◽  
Secondary Patency ◽  
Venous Anastomosis ◽  
Stent Deployment ◽  
Kaplan Meier ◽  
Secondary Patency Rate ◽  
Study Population ◽  
One Year

Background: Stents have been increasingly used for treating venous anastomosis stenosis seen in arteriovenous grafts (AVGs). A major reason for this trend is that stents can potentially confer a better patency rate compared to angioplasty. However, limited data are available about the outcomes of stents that are used to treat thigh AVG dysfunction. This study sought to assess the primary and secondary patency rates of stents used to treat thigh AVGs dysfunction at one year. Methods: This is a retrospective study of dialysis patients who received therapy via thigh grafts (N=50) and underwent stent placement between January 2005 and June 2017 at our center. Data on demographics and baseline characteristics of the study population were collected. The primary and secondary patency rates were defined as the time between stent deployment and the first intervention and second intervention, respectively. Patency and re-intervention rates were estimated using Kaplan-Meier survival analysis. Results: This study included 50 patients with thigh AVGs; mean age was 50.5± 15.5 years; 52% were female; 80% were black; and 90% had hypertension. The main indication for stenting was thrombosis due to venous anastomosis stenosis (74%). The number (mean ± SD) of stents deployed was 1.24 ± 0.8. The primary patency rate at three months and one year was 58.7% and 30.7%. In comparison, the secondary patency rate at three months and one year was 68.2% and 40.7% (p=0.04) Conclusions: Thigh AVG stenting can be successfully used to improve the overall patency rates of failing AVGs.

Endovascular Reconstruction for Total Aorto–Iliac Occlusion

2021 ◽  
pp. 152660282110599
Author(s):  
Gabriele Piffaretti ◽  
Aaron Thomas Fargion ◽  
Walter Dorigo ◽  
Raffaele Pulli ◽  
Michelangelo Ferri ◽  
...  
Keyword(s):  
Cox Regression ◽  
Aortic Surgery ◽  
Primary Patency ◽  
Secondary Patency ◽  
Infrarenal Aorta ◽  
Technical Success ◽  
Total Occlusion ◽  
Cox Regression Analysis ◽  
Iliac Bifurcation

Objectives: To analyze outcomes following endovascular treatment of total occlusion of the infrarenal aorta and aorto–iliac bifurcation in a multicenter Italian registry. Methods: It is a multicenter, retrospective, observational cohort study. From January 2015 to December 2018, 1306 endovascular interventions for aorto–iliac occlusive disease were recorded in the vascular registry. For this analysis, only patients treated for total occlusion of the infrarenal aorta and aorto–iliac bifurcation were included. Early (<30 days) primary outcomes of interest were technical success and mortality. Late major outcomes were primary and secondary patency and freedom from conversion to open aortic surgery. Results: A total of 54 (4.1%) patients met the inclusion criteria. Total percutaneous revascularization was possible in 41 (75.9%) patients and hybrid (endo plus open) intervention in 13 (24.1%) patients. The kissing-stent-graft technique was used in 45 (83.3%) cases, covered endovascular reconstruction of the aortic bifurcation (CERAB) in 5 (9.2%), and a unibody endograft deployed in 4 (7.4%). Technical success was 98.1% (n = 53). There were no episodes of intraoperative or perioperative vessel rupture. Conversion to open surgery was not necessary, and there were no in-hospital deaths. The median patient follow-up time was 16 months (interquartrile range [IQR], 6-27). The estimated primary patency rate was 95.8% ± 0.03 (95% confidence interval [CI]: 85.5-98.9) at 1 year, 91.4% ± 0.05 (95% CI: 76.2-97.2) at 2 years, and 85 ± 0.08 (95% CI: 64.5-94.6) at 3 years. Cox regression analysis demonstrated that sex (hazard ratio [HR]: 0.96; 95% CI: 0.15-6.23, p = 0.963), extent of the occlusion (HR: 0.28; 95% CI: 0.05-1.46, p = 0.130), calcium score (HR: 1.88; 95% CI: 0.31-11.27, p = 0.490), or type of endovascular reconstruction (HR: 0.80; 95% CI: 0.13-5.15, p = 0.804) did not affect primary patency. Secondary patency was 95.5% ± 0.04 (95% CI: 78.4-99.2) at 3 years. No patients required late conversion to open surgical bypass. Conclusions: Endovascular reconstruction for total occlusion of the infrarenal aorta and aorto–iliac bifurcation was successful using a combination of percutaneous and hybrid revascularization techniques. Estimated patency rates at 3 years of follow-up are promising and are unaffected by the extent of occlusion or type of revascularization.

Long-term patency rate of the translocated autologous saphenous vein versus prosthetic material in vascular access surgery for haemodialysis and parenteral nutrition

2021 ◽  
pp. 112972982110131
Author(s):  
Wouter Driessen ◽  
Wilbert van der Meijden ◽  
Geert Wanten ◽  
Frank van Hoek
Keyword(s):  
Parenteral Nutrition ◽  
Vascular Access ◽  
Saphenous Vein ◽  
Patency Rate ◽  
Primary Patency ◽  
Prosthetic Material ◽  
Secondary Patency ◽  
Kaplan Meier ◽  
Significant Difference

Objective: To evaluate the long-term patency rate of the arteriovenous angioaccess (AVA) with interposition of either autologous or prosthetic material as a last option for vascular access in the upper extremity. Methods: This is a retrospective chart review study of all patients who received an AVA with autologous saphenous vein (SV Group, n = 38) or prosthetic material (PTFE Group, n = 25) as a conduit from the year 1996 to 2020 in the Radboud University Medical Center (Radboudumc). Data were retrospectively extracted from two prospectively updated local databases for vascular access, one for haemodialysis (HD) and one for parenteral nutrition (PN). When required, the medical records of each patient were used. Data were eventually collected anonymously and analysed in SPSS 25. Kaplan-Meier life-tables were used for the statistical analysis. Results: Primary patency at 12 and 48 months was 30% and 20% in the SV group and 45% and 14% in the PTFE group. No significant difference was shown in the median primary patency rate ( p = 0.715). Secondary patency at 12 and 48 months was 63% and 39% in the SV group and 55% and 19% in the PTFE group. This was considered a significant difference in median secondary patency in favour of the SV with 41.16 ± 17.67 months against 13.77 ± 10.22 months for PTFE ( p = 0.032). The incidence of infection was significantly lower in the SV group ( p = 0.0002). A Kaplan-Meier curve could not detect a significant difference in secondary patency between the access for haemodialysis and the access for parenteral nutrition. The secondary patency of the SV in parenteral nutrition access, was significantly higher when compared with PTFE ( p = 0.004). Conclusion: The SV can be preferred over PTFE when conduit material is needed for long-term vascular access for HD or PN treatment due to its higher secondary patency and lower infection risk.

scholarly journals Endovascular Stent Placement for Hemodialysis Arteriovenous Access Stenosis

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Brendon L. Neuen ◽  
Richard A. Baer ◽  
Frank Grainer ◽  
Murty L. Mantha
Keyword(s):  
Stent Placement ◽  
Cox Regression ◽  
Primary Patency ◽  
Secondary Patency ◽  
Endovascular Stent ◽  
Upper Arm ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
Arteriovenous Access ◽  
Endovascular Stent Placement

This study aims to report the outcomes of nitinol and polytetrafluoroethylene covered stent placement to treat hemodialysis arteriovenous access stenosis at a single center over a five-year period. Clinical and radiological information was reviewed retrospectively. Poststent primary and secondary patency rates were determined using Kaplan-Meier analysis. Ten clinical variables were subjected to multivariate Cox regression analysis to determine predictors of patency after stent placement. During the study period 60 stents were deployed in 45 patients, with a mean follow-up of 24.5 months. The clinical and anatomical success rate was 98.3% (59/60). Poststent primary patency rates at 6, 12, and 24 months were 64%, 46%, and 35%, respectively. Poststent secondary patency rates at 6, 12, and 24 months were 95%, 89%, and 85%, respectively. Stent placement for upper arm lesions and in access less than 12 months of age was associated with reduced primary patency (adjusted hazards ratio [HR] 5.1,p=0.0084, and HR 3.5,p=0.0029, resp.). Resistant or recurrent stenosis can be successfully treated by endovascular stent placement with durable long-term patency, although multiple procedures are often required. Stent placement for upper arm lesions and in arteriovenous access less than 12 months of age was associated with increased risk of patency loss.

Comparison of side-to-end vs. side-to-side proximal arteriovenous fistula anastomosis in chronic renal failure patients

Vascular ◽  
2019 ◽  
Vol 27 (6) ◽  
pp. 628-635
Author(s):  
Gaspar Mestres ◽  
Begoña Gonzalo ◽  
Eduardo Mateos ◽  
Xavier Yugueros ◽  
Carlos Martínez-Rico ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Arteriovenous Fistula ◽  
Cox Regression ◽  
Independent Predictor ◽  
Patient Characteristics ◽  
Primary Patency ◽  
Secondary Patency ◽  
Arteriovenous Fistulas ◽  
Kaplan Meier

Introduction Anastomotic creation of autogenous arteriovenous fistulas can be performed in different ways, side-to-end or side-to-side. However, there is a paucity of evidence to recommend them. The aim of this study is to compare both anastomosis types in elbow arteriovenous fistulas. Material and methods A prospective observational national multicenter study (ISRCTN62033470) was designed, including patients receiving a native arteriovenous fistula in the elbow using side-to-end or side-to-side anastomosis, between September, 2016 and September, 2017, with six-month postoperative follow-up period. Patient characteristics, surgical details, and follow-up data (primary, assisted primary and secondary patency, maturation, functionality, complications) were recorded and compared between both anastomosis groups using Kaplan–Meier curves estimations, at one and six-month follow-up, and finally a multivariate analysis with Cox regression was performed. Results Three centers participated in the study, including 133 cases (96 side-to-end, 37 side-to-side). The cephalic vein was more often used for side-to-end (58.3%) and basilic for side-to-side (78.4%; P < 0.001). Side-to-end anastomoses were faster to create (65.1–75.1 min; P = 0.009). During follow-up, 23 cases were lost (transplanted, dead, ligated, or lost), with no differences at one month. At six months, primary patency was better for the side-to-end group (78.5 − 55.9%; P = 0.038), but it was not confirmed as an independent predictor in the multivariate analysis. Furthermore, no significant differences in assisted primary or secondary patency, maturation or functionality were seen. Patients with side-to-side anastomosis more often required vein superficialization (2.1–16.2%; P = 0.002) and presented more frequent puncture hematomas (4.9–30.0%; P = 0.015). Conclusions Anastomosis type was not significantly related to different outcomes in the follow-up. Even though side-to-end anastomosis showed better primary patency at six months with lower need of vein superficialization and fewer puncture hematomas during follow-up, it was not confirmed as an independent predictor in the multivariate analysis, and similar assisted primary and secondary patency, maturation, and functionality rates have been seen after arteriovenous fistula creation.

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