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Abstract: FR-PO490

Impact of Arteriovenous Fistula (AVF) Dysfunctional and Repeated Endovascular Procedures on AVF Intervention-Free Survival

Session Information

  • Dialysis: Vascular Access
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 803 Dialysis: Vascular Access

Authors

  • Bregoli, Alessandro, Universita degli Studi di Milano-Bicocca, Milano, Italy
  • Bellocchio, Francesco, Fresenius Medical Care Italia SpA, Palazzo Pignano, Lombardia, Italy
  • Garbelli, Mario, Fresenius Medical Care Italia SpA, Palazzo Pignano, Lombardia, Italy
  • Stuard, Stefano, Fresenius Medical Care Italia SpA, Palazzo Pignano, Lombardia, Italy
  • Nikam, Milind, Fresenius Medical Care Asia Pacific Ltd, Hong Kong, Hong Kong
  • Usvyat, Len A., Fresenius Medical Care, Waltham, Massachusetts, United States
  • Neri, Luca, Fresenius Medical Care Italia SpA, Palazzo Pignano, Lombardia, Italy
Background

Endoluminal and surgical procedure effectively re-establish patency of disfunctional Arteriovenous Fistulas (AVF); however, repeated intervention may reduce overall vascular access survival. We previously developed a risk score predicting AVF failure within 3 months that shows high accuracy and reproducibility. To enhance score interpretability we sought to assess its association with AVF intervention-free survival among patients with previous intervention to re-establish vascular access patency.

Methods

We included all patients receiving in-center hemodialysis therapy with an AVF in Nephrocare Portugues network between January 1st, 2015 and December 30th, 2022. We abstracted data from the European Clinical Database (EuCliD). We used generalized linear models to assess the association between the AVF failure risk score and intervention-free survival by the number of previous endoluminal interventions.

Results

We included 4,668 AVFs from 4,355 patients in the analytical dataset. Whereas patients with previous multiple endovascular procedures were common, only a small minority had more than 3 procedures. Both the AVF risk score class (p<0.01) and the number of previous endoluminal interventions (p<0.01) independently predicted AVF intervention-free survival (Fig. 1).

Conclusion

AVF intervention-free survival was associated with both AVF risk score classes and the number of previous endovascular procedures; both factors should be considered in evaluating the risk-benefit ratio of additional endoluminal procedure against alternative interventions for dysfunctional AVFs.

AVF intervention-free survival (in days) with respect to the number of previous endovascular procedures and AVF failure risk class