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Initiation of antiplatelet medication after surgical thrombectomy jeopardized arteriovenous graft longevity

Initiation of antiplatelet medication after surgical thrombectomy jeopardized arteriovenous graft longevity

J Vasc Access 2017; 18(3): 207 - 213

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/jva.5000660

Authors

Chi-Hsiao Yeh, Ting-Shuo Huang, Yao-Chang Wang, Pin-Fu Huang, Tzu-Yen Huang, Tzu-Ping Chen, Shun-Ying Yin

Abstract

Introduction

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.

Methods

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.

Results

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).

Conclusions

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.

Article History

Disclosures

Financial support: No grants or funding have been received for this study.
Conflict of interest: None of the authors has financial interest related to this study to disclose.

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Authors

Affiliations

  • 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

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