Comparative Effectiveness of Endovascular vs Surgical Arteriovenous Fistulas: A Preliminary Analysis
Presentation Type
Oral Presentation
Discipline Track
Clinical Science
Abstract Type
Research/Clinical
Abstract
Purpose: The objective of this study was to compare the efficacy and safety of endovascular arteriovenous fistula (endoAVF) creation versus open surgical AVF (openAVF) for hemodialysis access across centers participating in the Dialysis Access Learning and Innovation Collaborative (DiAL-In Collaborative) in the United States. In this preliminary analysis, we report the baseline characteristics and clinical profile of patients enrolled at a single center.
Materials and Methods: A retrospective cohort study was conducted in chronic kidney disease patients who underwent creation of an upper arm autogenous vascular access for hemodialysis (2018-2022) at the Brigham and Women’s Hospital in Boston, MA. Data were gathered from the Vascular Quality Initiative dataset and supplemented with chart adjudication. All patients were followed for a minimum of one year with a maximum follow-up until July 2023.
Results: A total of 145 patients were enrolled (13 endoAVF and 132 openAVF). Overall, 67% of patients were hemodialysis dependent and 2% were peritoneal dialysis dependent at the time of fistula creation. Patients with an endoAVF were older (75 vs. 67 years; p= 0.073), and more likely to be male (62% vs. 48%; p= 0.047 ). The openAVF cohort had a higher proportion of patients with medical comorbidities such as congestive heart failure (44% vs. 31%; p= 0.057), history of percutaneous coronary intervention (19% vs. 8%; p= 0.022), and diabetes (58% vs. 46%; p=.089).
Conclusions: In this single-center preliminary analysis, we found differences in the baseline demographic and clinical profile of patients undergoing endoAVF and openAVF for hemodialysis. A thoughtful analytical approach will need to be employed to account for these important baseline differences to compare outcomes of endoAVF versus openAVF in the multicenter DiAL-In Collaborative.
Recommended Citation
Cruz, Melissa M.; Fitzgibbon, James J.; Heindel, Patrick; and Hussain, Mohamad, "Comparative Effectiveness of Endovascular vs Surgical Arteriovenous Fistulas: A Preliminary Analysis" (2024). Research Symposium. 11.
https://scholarworks.utrgv.edu/somrs/2024/talks/11
Included in
Comparative Effectiveness of Endovascular vs Surgical Arteriovenous Fistulas: A Preliminary Analysis
Purpose: The objective of this study was to compare the efficacy and safety of endovascular arteriovenous fistula (endoAVF) creation versus open surgical AVF (openAVF) for hemodialysis access across centers participating in the Dialysis Access Learning and Innovation Collaborative (DiAL-In Collaborative) in the United States. In this preliminary analysis, we report the baseline characteristics and clinical profile of patients enrolled at a single center.
Materials and Methods: A retrospective cohort study was conducted in chronic kidney disease patients who underwent creation of an upper arm autogenous vascular access for hemodialysis (2018-2022) at the Brigham and Women’s Hospital in Boston, MA. Data were gathered from the Vascular Quality Initiative dataset and supplemented with chart adjudication. All patients were followed for a minimum of one year with a maximum follow-up until July 2023.
Results: A total of 145 patients were enrolled (13 endoAVF and 132 openAVF). Overall, 67% of patients were hemodialysis dependent and 2% were peritoneal dialysis dependent at the time of fistula creation. Patients with an endoAVF were older (75 vs. 67 years; p= 0.073), and more likely to be male (62% vs. 48%; p= 0.047 ). The openAVF cohort had a higher proportion of patients with medical comorbidities such as congestive heart failure (44% vs. 31%; p= 0.057), history of percutaneous coronary intervention (19% vs. 8%; p= 0.022), and diabetes (58% vs. 46%; p=.089).
Conclusions: In this single-center preliminary analysis, we found differences in the baseline demographic and clinical profile of patients undergoing endoAVF and openAVF for hemodialysis. A thoughtful analytical approach will need to be employed to account for these important baseline differences to compare outcomes of endoAVF versus openAVF in the multicenter DiAL-In Collaborative.