The efficacy of antiplatelet agents in preventing thrombosis in newly formed arteriovenous graft (AVG) in hemodialysis (HD) patients has been extensively examined. The aim of this study was to investigate the possible effect of initiation of antiplatelet medications on preventing AVG thrombosis recurrence after surgical thrombectomy for acute occlusion in HD patients. Whether post-operatively antiplatelet medications have protective effects on the patency or longevity of AVG after surgical thrombectomy in HD patients has not been investigated.
We conducted a 4-year quasi-randomized study of the unassisted patency and AVG longevity for 213 HD patients with or without initiating antiplatelet drugs after receiving surgical thrombectomy for first episode of acute AVG thrombosis.
From the propensity-score-matched quasi-randomized study, initiation of antiplatelet drugs after first surgical thrombectomy in HD patients did not prevent the recurrence of surgical thrombectomy (log-rank p = 0.81), but significantly decreased the longevity of the access (log-rank p = 0.034). Multivariate Cox model demonstrated that prescription of antiplatelet drugs significantly increased the risk of graft failure (adjusted hazard ratio 2.13, p = 0.025).
Adjunctive prescription with antiplatelet medications in HD patients after surgical thrombectomy did not prevent recurrent thrombosis of AV access, but significantly jeopardized the longevity of AVG after surgical thrombectomy.
J Vasc Access 2017; 18(3): 207 - 213
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsChi-Hsiao Yeh, Ting-Shuo Huang, Yao-Chang Wang, Pin-Fu Huang, Tzu-Yen Huang, Tzu-Ping Chen, Shun-Ying Yin
- • Accepted on 07/12/2016
- • Available online on 28/04/2017
- • Published in print on 15/05/2017
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- Yeh, Chi-Hsiao [PubMed] [Google Scholar] 1, 2, * Corresponding Author (firstname.lastname@example.org)
- Huang, Ting-Shuo [PubMed] [Google Scholar] 2, 3
- Wang, Yao-Chang [PubMed] [Google Scholar] 1
- Huang, Pin-Fu [PubMed] [Google Scholar] 1
- Huang, Tzu-Yen [PubMed] [Google Scholar] 1
- Chen, Tzu-Ping [PubMed] [Google Scholar] 1
- Yin, Shun-Ying [PubMed] [Google Scholar] 1
Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan - ROC
College of Medicine, Chang Gung University, Tao-Yuan, Taiwan - ROC
Department of General Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan - ROC