Effects of Heparin on Early Patency of Arteriovenous Fistula in Angioaccess Surgery of Patients With End-Stage Renal Disease
Overview
- Phase
- Phase 4
- Intervention
- Heparin
- Conditions
- Arteriovenous Fistula
- Sponsor
- Fatemeh Hoseinzadegan
- Enrollment
- 150
- Primary Endpoint
- The number of patients with a bruit auscultated over AVF
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
Arteriovenous fistula (AVF) is now the optimal method of obtaining vascular access for dialysis. Measures such as systemic anticoagulation have been proposed as means of increasing patency rates but enough evidence does not exist to support their use. The investigators aimed to evaluate the efficacy of preoperative heparin injection on patency of AVF during the first 24 hours after surgery and to determine whether such measure can be used to prevent early thrombosis of the vascular access.
Detailed Description
The study was carried out on patients admitted to Shohada-e-Tajrish hospital for permanent vascular access placement since April 2011 through September 2012. The exclusion criteria consisted of having a contraindication of administration of anticuagulant agent. 150 patients were enrolled in the study. All patients were operated on by a single surgeon (Dr Mozafar. The non dominant upper extremity (mostly the left arm) was generally used unless unfavorable vasculature or previous fistula placement changed the preference. The anastomosis technique was either end-to-side or side-to-side using a number 6.0 prolene suture. 75 patients were randomly assigned to receive 100units/kg of heparin after dissection prior to anastomosis while the other 75 received no intraoperative heparin injection. Auscultation of bruit and palpation of thrill was used to assess arteriovenous fistula patency in the first 24 hours after AVF placement. Data analysis was performed using SPSS v.20. A p-value of less than 0.05 was considered as statistically significant. Bivariate analysis in the form of Chi-square tests, T-test and Fischer's exact test were calculated. Patient enrollment was voluntary and no costs were imposed on the patients. The study protocol was in accordance with 1975 Declaration of Helsinki.
Investigators
Fatemeh Hoseinzadegan
Dr.
Shahid Beheshti University of Medical Sciences
Eligibility Criteria
Inclusion Criteria
- •Chronic Kidney Disease, In need of AVF placement
Exclusion Criteria
- •Contraindications for anticoagulant therapy
Arms & Interventions
Heparin
75 patients were randomly assigned to receive 100units/kg of heparin after dissection prior to anastomosis.
Intervention: Heparin
Outcomes
Primary Outcomes
The number of patients with a bruit auscultated over AVF
Time Frame: The first 24 hours after anostomosis
Hearing a bruit through auscultation over the AVF is regarded as a positive measure or in other words a patent AVF. The frequency of positive measures are compared between the two groups.