Multiple preoperative and intraoperative factors predict early fistula thrombosis in the Hemodialysis Fistula Maturation Study

Alik Farber, Peter B. Imrey, Thomas S. Huber, James M. Kaufman, Larry W. Kraiss, Brett Larive, Liang Li, Harold I. Feldman, H. Feldman, L. Dember, J. Kaufman, L. Stern, P. Lesage, C. Kivork, D. Soares, M. Malikova, M. Allon, C. Young, M. Taylor, L. Woodard & 82 others K. Mangadi, P. Roy-Chaudhury, R. Munda, T. Lee, R. Alloway, M. El-Khatib, T. Canaan, A. Pflum, L. Thieken, B. Campos-Naciff, T. Huber, S. Berceli, M. Jansen, G. McCaslin, Y. Trahan, M. Vazquez, W. Vongpatanasin, I. Davidson, C. Hwang, T. Lightfoot, C. Livingston, A. Valencia, B. Dolmatch, A. Fenves, N. Hawkins, A. Cheung, L. Kraiss, D. Kinikini, G. Treiman, D. Ihnat, M. Sarfati, I. Lavasani, M. Maloney, L. Schlotfeldt, J. Himmelfarb, C. Buchanan, C. Clark, C. Crawford, J. Hamlett, J. Kundzins, L. Manahan, J. Wise, G. Beck, J. Gassman, T. Greene, P. Imrey, J. Alster, M. Li, J. Mackrell, M. Radeva, B. Weiss, K. Wiggins, C. Alpers, K. Hudkins, T. Wietecha, M. Robbin, H. Umphrey, L. Alexander, C. Abts, L. Belt, J. Vita, N. Hamburg, M. Duess, A. Levit, H. Higgins, S. Ke, O. Mandaci, C. Snell, J. Gravley, S. Behnken, R. Mortensen, G. Chertow, A. Besarab, K. Brayman, M. Diener-West, D. Harrison, L. Inker, T. Louis, W. McClellan, J. Rubin, J. Kusek, R. Star

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Objective Early thrombosis (ET) contributes to autogenous arteriovenous fistula (AVF) failure. We studied patients undergoing AVF placement in the Hemodialysis Fistula Maturation Study, a prospective, observational cohort study, using a nested case-control analysis to identify preoperative and intraoperative predictors of ET. Methods ET cases were compared with controls, who were matched for gender, age, diabetes, dialysis status, and surgeon fistula volume. ET was defined as thrombosis diagnosed by physical examination or ultrasound within 18 days of AVF creation. Conditional logistic regression models were fit to identify risk factors for ET. Results Thirty-two ET cases (5.3%) occurred among 602 study participants; 198 controls were matched. ET was associated with female gender (odds ratio [OR], 2.75; 95% confidence interval [CI], 1.19-6.38; P =.018), fistula location (forearm vs upper arm; OR, 2.76; 95% CI, 1.05-7.23; P =.039), feeding artery (radial vs brachial; OR, 2.64; 95% CI, 1.03-6.77; P =.043) and arterial diameter (OR, 1.52; 95% CI, 1.02-2.26; P =.039, per mm smaller). The draining vein diameter was nonlinearly associated with ET, with highest risk in 2- to 3-mm veins. Surprisingly, ET risk was lower in diabetics (OR, 0.19; 95% CI, 0.07-0.47; P =.0004), lower with less nitroglycerin-mediated brachial artery dilation (OR, 0.42; 95% CI, 0.20-1.92; P =.029 for each 10% lower) and higher with lower carotid-femoral pulse wave velocity (OR, 1.49; 95% CI, 1.02-2.20; P =.041, for each m/s lower). Intraoperative protamine use was associated with a higher ET risk (OR, 3.26; 95% CI, 1.28-∞; P =.038). Surgeon's intraoperative perceptions were associated with ET: surgeons' greater concern about maturation success (likely, marginal, unlikely) was associated with higher thrombosis risk (OR, 8.09; 95% CI, 4.03-∞; P

Original languageEnglish (US)
Pages (from-to)163-170e6
JournalJournal of Vascular Surgery
Volume63
Issue number1
DOIs
StatePublished - Jan 1 2016

Fingerprint

Fistula
Renal Dialysis
Thrombosis
Odds Ratio
Confidence Intervals
Arteriovenous Fistula
Veins
Arm
Logistic Models
Pulse Wave Analysis
Radial Artery
Protamines
Brachial Artery
Nitroglycerin
Thigh
Forearm
Physical Examination
Observational Studies
Dilatation
Dialysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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Multiple preoperative and intraoperative factors predict early fistula thrombosis in the Hemodialysis Fistula Maturation Study. / Farber, Alik; Imrey, Peter B.; Huber, Thomas S.; Kaufman, James M.; Kraiss, Larry W.; Larive, Brett; Li, Liang; Feldman, Harold I.; Feldman, H.; Dember, L.; Kaufman, J.; Stern, L.; Lesage, P.; Kivork, C.; Soares, D.; Malikova, M.; Allon, M.; Young, C.; Taylor, M.; Woodard, L.; Mangadi, K.; Roy-Chaudhury, P.; Munda, R.; Lee, T.; Alloway, R.; El-Khatib, M.; Canaan, T.; Pflum, A.; Thieken, L.; Campos-Naciff, B.; Huber, T.; Berceli, S.; Jansen, M.; McCaslin, G.; Trahan, Y.; Vazquez, M.; Vongpatanasin, W.; Davidson, I.; Hwang, C.; Lightfoot, T.; Livingston, C.; Valencia, A.; Dolmatch, B.; Fenves, A.; Hawkins, N.; Cheung, A.; Kraiss, L.; Kinikini, D.; Treiman, G.; Ihnat, D.; Sarfati, M.; Lavasani, I.; Maloney, M.; Schlotfeldt, L.; Himmelfarb, J.; Buchanan, C.; Clark, C.; Crawford, C.; Hamlett, J.; Kundzins, J.; Manahan, L.; Wise, J.; Beck, G.; Gassman, J.; Greene, T.; Imrey, P.; Alster, J.; Li, M.; Mackrell, J.; Radeva, M.; Weiss, B.; Wiggins, K.; Alpers, C.; Hudkins, K.; Wietecha, T.; Robbin, M.; Umphrey, H.; Alexander, L.; Abts, C.; Belt, L.; Vita, J.; Hamburg, N.; Duess, M.; Levit, A.; Higgins, H.; Ke, S.; Mandaci, O.; Snell, C.; Gravley, J.; Behnken, S.; Mortensen, R.; Chertow, G.; Besarab, A.; Brayman, K.; Diener-West, M.; Harrison, D.; Inker, L.; Louis, T.; McClellan, W.; Rubin, J.; Kusek, J.; Star, R.

In: Journal of Vascular Surgery, Vol. 63, No. 1, 01.01.2016, p. 163-170e6.

Research output: Contribution to journalArticle

Farber, A, Imrey, PB, Huber, TS, Kaufman, JM, Kraiss, LW, Larive, B, Li, L, Feldman, HI, Feldman, H, Dember, L, Kaufman, J, Stern, L, Lesage, P, Kivork, C, Soares, D, Malikova, M, Allon, M, Young, C, Taylor, M, Woodard, L, Mangadi, K, Roy-Chaudhury, P, Munda, R, Lee, T, Alloway, R, El-Khatib, M, Canaan, T, Pflum, A, Thieken, L, Campos-Naciff, B, Huber, T, Berceli, S, Jansen, M, McCaslin, G, Trahan, Y, Vazquez, M, Vongpatanasin, W, Davidson, I, Hwang, C, Lightfoot, T, Livingston, C, Valencia, A, Dolmatch, B, Fenves, A, Hawkins, N, Cheung, A, Kraiss, L, Kinikini, D, Treiman, G, Ihnat, D, Sarfati, M, Lavasani, I, Maloney, M, Schlotfeldt, L, Himmelfarb, J, Buchanan, C, Clark, C, Crawford, C, Hamlett, J, Kundzins, J, Manahan, L, Wise, J, Beck, G, Gassman, J, Greene, T, Imrey, P, Alster, J, Li, M, Mackrell, J, Radeva, M, Weiss, B, Wiggins, K, Alpers, C, Hudkins, K, Wietecha, T, Robbin, M, Umphrey, H, Alexander, L, Abts, C, Belt, L, Vita, J, Hamburg, N, Duess, M, Levit, A, Higgins, H, Ke, S, Mandaci, O, Snell, C, Gravley, J, Behnken, S, Mortensen, R, Chertow, G, Besarab, A, Brayman, K, Diener-West, M, Harrison, D, Inker, L, Louis, T, McClellan, W, Rubin, J, Kusek, J & Star, R 2016, 'Multiple preoperative and intraoperative factors predict early fistula thrombosis in the Hemodialysis Fistula Maturation Study', Journal of Vascular Surgery, vol. 63, no. 1, pp. 163-170e6. https://doi.org/10.1016/j.jvs.2015.07.086
Farber, Alik ; Imrey, Peter B. ; Huber, Thomas S. ; Kaufman, James M. ; Kraiss, Larry W. ; Larive, Brett ; Li, Liang ; Feldman, Harold I. ; Feldman, H. ; Dember, L. ; Kaufman, J. ; Stern, L. ; Lesage, P. ; Kivork, C. ; Soares, D. ; Malikova, M. ; Allon, M. ; Young, C. ; Taylor, M. ; Woodard, L. ; Mangadi, K. ; Roy-Chaudhury, P. ; Munda, R. ; Lee, T. ; Alloway, R. ; El-Khatib, M. ; Canaan, T. ; Pflum, A. ; Thieken, L. ; Campos-Naciff, B. ; Huber, T. ; Berceli, S. ; Jansen, M. ; McCaslin, G. ; Trahan, Y. ; Vazquez, M. ; Vongpatanasin, W. ; Davidson, I. ; Hwang, C. ; Lightfoot, T. ; Livingston, C. ; Valencia, A. ; Dolmatch, B. ; Fenves, A. ; Hawkins, N. ; Cheung, A. ; Kraiss, L. ; Kinikini, D. ; Treiman, G. ; Ihnat, D. ; Sarfati, M. ; Lavasani, I. ; Maloney, M. ; Schlotfeldt, L. ; Himmelfarb, J. ; Buchanan, C. ; Clark, C. ; Crawford, C. ; Hamlett, J. ; Kundzins, J. ; Manahan, L. ; Wise, J. ; Beck, G. ; Gassman, J. ; Greene, T. ; Imrey, P. ; Alster, J. ; Li, M. ; Mackrell, J. ; Radeva, M. ; Weiss, B. ; Wiggins, K. ; Alpers, C. ; Hudkins, K. ; Wietecha, T. ; Robbin, M. ; Umphrey, H. ; Alexander, L. ; Abts, C. ; Belt, L. ; Vita, J. ; Hamburg, N. ; Duess, M. ; Levit, A. ; Higgins, H. ; Ke, S. ; Mandaci, O. ; Snell, C. ; Gravley, J. ; Behnken, S. ; Mortensen, R. ; Chertow, G. ; Besarab, A. ; Brayman, K. ; Diener-West, M. ; Harrison, D. ; Inker, L. ; Louis, T. ; McClellan, W. ; Rubin, J. ; Kusek, J. ; Star, R. / Multiple preoperative and intraoperative factors predict early fistula thrombosis in the Hemodialysis Fistula Maturation Study. In: Journal of Vascular Surgery. 2016 ; Vol. 63, No. 1. pp. 163-170e6.
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title = "Multiple preoperative and intraoperative factors predict early fistula thrombosis in the Hemodialysis Fistula Maturation Study",
abstract = "Objective Early thrombosis (ET) contributes to autogenous arteriovenous fistula (AVF) failure. We studied patients undergoing AVF placement in the Hemodialysis Fistula Maturation Study, a prospective, observational cohort study, using a nested case-control analysis to identify preoperative and intraoperative predictors of ET. Methods ET cases were compared with controls, who were matched for gender, age, diabetes, dialysis status, and surgeon fistula volume. ET was defined as thrombosis diagnosed by physical examination or ultrasound within 18 days of AVF creation. Conditional logistic regression models were fit to identify risk factors for ET. Results Thirty-two ET cases (5.3{\%}) occurred among 602 study participants; 198 controls were matched. ET was associated with female gender (odds ratio [OR], 2.75; 95{\%} confidence interval [CI], 1.19-6.38; P =.018), fistula location (forearm vs upper arm; OR, 2.76; 95{\%} CI, 1.05-7.23; P =.039), feeding artery (radial vs brachial; OR, 2.64; 95{\%} CI, 1.03-6.77; P =.043) and arterial diameter (OR, 1.52; 95{\%} CI, 1.02-2.26; P =.039, per mm smaller). The draining vein diameter was nonlinearly associated with ET, with highest risk in 2- to 3-mm veins. Surprisingly, ET risk was lower in diabetics (OR, 0.19; 95{\%} CI, 0.07-0.47; P =.0004), lower with less nitroglycerin-mediated brachial artery dilation (OR, 0.42; 95{\%} CI, 0.20-1.92; P =.029 for each 10{\%} lower) and higher with lower carotid-femoral pulse wave velocity (OR, 1.49; 95{\%} CI, 1.02-2.20; P =.041, for each m/s lower). Intraoperative protamine use was associated with a higher ET risk (OR, 3.26; 95{\%} CI, 1.28-∞; P =.038). Surgeon's intraoperative perceptions were associated with ET: surgeons' greater concern about maturation success (likely, marginal, unlikely) was associated with higher thrombosis risk (OR, 8.09; 95{\%} CI, 4.03-∞; P",
author = "Alik Farber and Imrey, {Peter B.} and Huber, {Thomas S.} and Kaufman, {James M.} and Kraiss, {Larry W.} and Brett Larive and Liang Li and Feldman, {Harold I.} and H. Feldman and L. Dember and J. Kaufman and L. Stern and P. Lesage and C. Kivork and D. Soares and M. Malikova and M. Allon and C. Young and M. Taylor and L. Woodard and K. Mangadi and P. Roy-Chaudhury and R. Munda and T. Lee and R. Alloway and M. El-Khatib and T. Canaan and A. Pflum and L. Thieken and B. Campos-Naciff and T. Huber and S. Berceli and M. Jansen and G. McCaslin and Y. Trahan and M. Vazquez and W. Vongpatanasin and I. Davidson and C. Hwang and T. Lightfoot and C. Livingston and A. Valencia and B. Dolmatch and A. Fenves and N. Hawkins and A. Cheung and L. Kraiss and D. Kinikini and G. Treiman and D. Ihnat and M. Sarfati and I. Lavasani and M. Maloney and L. Schlotfeldt and J. Himmelfarb and C. Buchanan and C. Clark and C. Crawford and J. Hamlett and J. Kundzins and L. Manahan and J. Wise and G. Beck and J. Gassman and T. Greene and P. Imrey and J. Alster and M. Li and J. Mackrell and M. Radeva and B. Weiss and K. Wiggins and C. Alpers and K. Hudkins and T. Wietecha and M. Robbin and H. Umphrey and L. Alexander and C. Abts and L. Belt and J. Vita and N. Hamburg and M. Duess and A. Levit and H. Higgins and S. Ke and O. Mandaci and C. Snell and J. Gravley and S. Behnken and R. Mortensen and G. Chertow and A. Besarab and K. Brayman and M. Diener-West and D. Harrison and L. Inker and T. Louis and W. McClellan and J. Rubin and J. Kusek and R. Star",
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TY - JOUR

T1 - Multiple preoperative and intraoperative factors predict early fistula thrombosis in the Hemodialysis Fistula Maturation Study

AU - Farber, Alik

AU - Imrey, Peter B.

AU - Huber, Thomas S.

AU - Kaufman, James M.

AU - Kraiss, Larry W.

AU - Larive, Brett

AU - Li, Liang

AU - Feldman, Harold I.

AU - Feldman, H.

AU - Dember, L.

AU - Kaufman, J.

AU - Stern, L.

AU - Lesage, P.

AU - Kivork, C.

AU - Soares, D.

AU - Malikova, M.

AU - Allon, M.

AU - Young, C.

AU - Taylor, M.

AU - Woodard, L.

AU - Mangadi, K.

AU - Roy-Chaudhury, P.

AU - Munda, R.

AU - Lee, T.

AU - Alloway, R.

AU - El-Khatib, M.

AU - Canaan, T.

AU - Pflum, A.

AU - Thieken, L.

AU - Campos-Naciff, B.

AU - Huber, T.

AU - Berceli, S.

AU - Jansen, M.

AU - McCaslin, G.

AU - Trahan, Y.

AU - Vazquez, M.

AU - Vongpatanasin, W.

AU - Davidson, I.

AU - Hwang, C.

AU - Lightfoot, T.

AU - Livingston, C.

AU - Valencia, A.

AU - Dolmatch, B.

AU - Fenves, A.

AU - Hawkins, N.

AU - Cheung, A.

AU - Kraiss, L.

AU - Kinikini, D.

AU - Treiman, G.

AU - Ihnat, D.

AU - Sarfati, M.

AU - Lavasani, I.

AU - Maloney, M.

AU - Schlotfeldt, L.

AU - Himmelfarb, J.

AU - Buchanan, C.

AU - Clark, C.

AU - Crawford, C.

AU - Hamlett, J.

AU - Kundzins, J.

AU - Manahan, L.

AU - Wise, J.

AU - Beck, G.

AU - Gassman, J.

AU - Greene, T.

AU - Imrey, P.

AU - Alster, J.

AU - Li, M.

AU - Mackrell, J.

AU - Radeva, M.

AU - Weiss, B.

AU - Wiggins, K.

AU - Alpers, C.

AU - Hudkins, K.

AU - Wietecha, T.

AU - Robbin, M.

AU - Umphrey, H.

AU - Alexander, L.

AU - Abts, C.

AU - Belt, L.

AU - Vita, J.

AU - Hamburg, N.

AU - Duess, M.

AU - Levit, A.

AU - Higgins, H.

AU - Ke, S.

AU - Mandaci, O.

AU - Snell, C.

AU - Gravley, J.

AU - Behnken, S.

AU - Mortensen, R.

AU - Chertow, G.

AU - Besarab, A.

AU - Brayman, K.

AU - Diener-West, M.

AU - Harrison, D.

AU - Inker, L.

AU - Louis, T.

AU - McClellan, W.

AU - Rubin, J.

AU - Kusek, J.

AU - Star, R.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Objective Early thrombosis (ET) contributes to autogenous arteriovenous fistula (AVF) failure. We studied patients undergoing AVF placement in the Hemodialysis Fistula Maturation Study, a prospective, observational cohort study, using a nested case-control analysis to identify preoperative and intraoperative predictors of ET. Methods ET cases were compared with controls, who were matched for gender, age, diabetes, dialysis status, and surgeon fistula volume. ET was defined as thrombosis diagnosed by physical examination or ultrasound within 18 days of AVF creation. Conditional logistic regression models were fit to identify risk factors for ET. Results Thirty-two ET cases (5.3%) occurred among 602 study participants; 198 controls were matched. ET was associated with female gender (odds ratio [OR], 2.75; 95% confidence interval [CI], 1.19-6.38; P =.018), fistula location (forearm vs upper arm; OR, 2.76; 95% CI, 1.05-7.23; P =.039), feeding artery (radial vs brachial; OR, 2.64; 95% CI, 1.03-6.77; P =.043) and arterial diameter (OR, 1.52; 95% CI, 1.02-2.26; P =.039, per mm smaller). The draining vein diameter was nonlinearly associated with ET, with highest risk in 2- to 3-mm veins. Surprisingly, ET risk was lower in diabetics (OR, 0.19; 95% CI, 0.07-0.47; P =.0004), lower with less nitroglycerin-mediated brachial artery dilation (OR, 0.42; 95% CI, 0.20-1.92; P =.029 for each 10% lower) and higher with lower carotid-femoral pulse wave velocity (OR, 1.49; 95% CI, 1.02-2.20; P =.041, for each m/s lower). Intraoperative protamine use was associated with a higher ET risk (OR, 3.26; 95% CI, 1.28-∞; P =.038). Surgeon's intraoperative perceptions were associated with ET: surgeons' greater concern about maturation success (likely, marginal, unlikely) was associated with higher thrombosis risk (OR, 8.09; 95% CI, 4.03-∞; P

AB - Objective Early thrombosis (ET) contributes to autogenous arteriovenous fistula (AVF) failure. We studied patients undergoing AVF placement in the Hemodialysis Fistula Maturation Study, a prospective, observational cohort study, using a nested case-control analysis to identify preoperative and intraoperative predictors of ET. Methods ET cases were compared with controls, who were matched for gender, age, diabetes, dialysis status, and surgeon fistula volume. ET was defined as thrombosis diagnosed by physical examination or ultrasound within 18 days of AVF creation. Conditional logistic regression models were fit to identify risk factors for ET. Results Thirty-two ET cases (5.3%) occurred among 602 study participants; 198 controls were matched. ET was associated with female gender (odds ratio [OR], 2.75; 95% confidence interval [CI], 1.19-6.38; P =.018), fistula location (forearm vs upper arm; OR, 2.76; 95% CI, 1.05-7.23; P =.039), feeding artery (radial vs brachial; OR, 2.64; 95% CI, 1.03-6.77; P =.043) and arterial diameter (OR, 1.52; 95% CI, 1.02-2.26; P =.039, per mm smaller). The draining vein diameter was nonlinearly associated with ET, with highest risk in 2- to 3-mm veins. Surprisingly, ET risk was lower in diabetics (OR, 0.19; 95% CI, 0.07-0.47; P =.0004), lower with less nitroglycerin-mediated brachial artery dilation (OR, 0.42; 95% CI, 0.20-1.92; P =.029 for each 10% lower) and higher with lower carotid-femoral pulse wave velocity (OR, 1.49; 95% CI, 1.02-2.20; P =.041, for each m/s lower). Intraoperative protamine use was associated with a higher ET risk (OR, 3.26; 95% CI, 1.28-∞; P =.038). Surgeon's intraoperative perceptions were associated with ET: surgeons' greater concern about maturation success (likely, marginal, unlikely) was associated with higher thrombosis risk (OR, 8.09; 95% CI, 4.03-∞; P

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UR - http://www.scopus.com/inward/citedby.url?scp=84955488047&partnerID=8YFLogxK

U2 - 10.1016/j.jvs.2015.07.086

DO - 10.1016/j.jvs.2015.07.086

M3 - Article

VL - 63

SP - 163-170e6

JO - Journal of Vascular Surgery

JF - Journal of Vascular Surgery

SN - 0741-5214

IS - 1

ER -