Arteriovenous Fistula Clinical Trial
Official title:
Effects of Heparin on Early Patency of Arteriovenous Fistula in Angioaccess Surgery of Patients With End-Stage Renal Disease
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.
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.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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