Fistula, Graft Angioplasty Success Linked to Aspirin Use

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In a prospective study, aspirin users were more likely to have a successful outcome following PTA for venous stenoses in arteriovenous fistulas or grafts.
In a prospective study, aspirin users were more likely to have a successful outcome following PTA for venous stenoses in arteriovenous fistulas or grafts.

AUSTIN, Texas—Aspirin use may associated with successful outcomes after percutaneous transluminal angioplasty (PTA) of hemodialysis (HD) fistulas and grafts, according to study findings presented at the National Kidney Foundation's 2018 Spring Clinical Meetings.

In a study of 80 HD patients who underwent PTA for venous stenoses in arteriovenous fistulas or grafts, Malgorzata A. Kochanek, MD, and colleagues from the University of Chicago found that 66.1% of the 56 patients who had a successful outcome were aspirin users compared with 33.3% of the 24 patients who did not have a successful outcome, a significant difference between the groups.

The investigators defined a success outcome as a dialyzer blood flow rate of 450 mL/min during dialysis without prolonged bleeding, cannulation pain, high venous pressure, low arterial pressure, pulling clots, infiltrations, poor clearance, infections, or swelling of the arm, neck, or head.

In addition, Dr Kochanek's group found that patients with a successful vs unsuccessful outcome were significantly more likely to have high venous pressure as the indication for PTA (64.3% vs 33.3%).

“We could not demonstrate any significant associations between procedural success and any anatomic features or measurements,” the authors concluded.

The study population, which was 98.8% black and 52.5% women, had a mean age of 58.4 years and mean body mass index of 28.8 kg/m2. Of the 80 patients, 42.5% had multiple venous stenoses. The investigators ascertained clinical outcomes 1 month after PTA.

Reference

Kochanek MA, McGill R, Navuluri R, Hammes M. Impact of aspirin use on outcomes after percutaneous angioplasty of hemodialysis fistulas and grafts. Poster presented at the National Kidney Foundation's 2018 Spring Clinical Meetings in Austin, Texas, April 10-14.

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