SAN DIEGO—Arteriovenous (AV) fistula patency rates, even after intervention with angioplasty, do not differ between younger and older hemodialysis patients, according to new data presented here at the Society of Interventional Radiology’s 34th Annual Scientific Meeting.
“Elderly patients’ arteriovenous fistulas responded just as well as those in younger patients in length of time the access stayed open and in moving blood efficiently,” said study investigator Andrew Forauer, MD, associate professor of interventional radiology at Dartmouth-Hitchcock Medical Center, Lebanon, N.H. “An AV fistula is the preferred access at any age.”
The researchers studied 72 patients, of whom 36 were aged 40-60 years and 36 were aged 75 years and older. They observed no significant difference in primary patency (a mean 298 days in younger group and 373 days in the older group), primary assisted patency (470 vs. 663 days), secondary patency (522 vs. 701 days), post-angioplasty primary patency (221 days and 200 days). Time on hemodialysis prior to AV fistula placement appeared to have no significant impact on any of the patency outcomes, Dr. Forauer said.
Elderly patients were more likely to be affected by cardiovascular disease, have anticoagulants prescribed and have a reduced ejection fraction, the investigators reported.
“We hear from clinicians and even patients that older patients who go on dialysis don’t do well,” Dr. Forauer said. “But what we found is that older patients’ fistulas don’t do any worse than younger patients. This study shows that, based on age alone, if a patient is healthy enough to get a fistula, then he or she should get a fistula. Secondly, it now adds to a clinician’s knowledge base and it can add to their decision-making.”