title: Effects of Antiplatelet Medication on Arteriovenous Fistula Patency After Surgical Thrombectomy.
abstract: To study the effect of antiplatelet agents on preventing arteriovenous (AV) fistulae thrombosis in hemodialysis (HD) patients after surgical thrombectomy (ST) for acute AV fistulae occlusion. Whether post-operative antiplatelet drugs have similar effects on the patency of AV fistula after surgical thrombectomy in patients with end-stage renal disease who undergo HD has not been investigated.
  
  
  
  We employed the Taiwan National Health Insurance Research Database (NHIRD) from 1999 to 2010 to assess the recurrent occlusion requiring ST and longevity of AV fistula after ST in 1049 patients on regular HD, with or without antiplatelet drugs.
  
  
  
  From the propensity-score (PS)-matched NHIRD, Multivariate Cox model demonstrated that concomitant antiplatelet medication in the HD patients who received the first ST significantly reduced the duration of recurrent ST (adjusted hazard ratio (HR) 1.69; 95% confidence interval (CI) 1.22-2.35, p=0.002) and the longevity of the fistula (adjusted HR 1.79; 95% CI 1.31-2.46, p<0.001).
  
  
  
  Treatment with antiplatelet drugs in HD patients did not prevent recurrent thrombosis requiring further ST, but significantly jeopardized the longevity of AV fistula after ST.
authors.affiliation: Division of Thoracic &amp: Cardiovascular Surgery, Chang Gung Memorial Hospital, 222 Mai-Chin Road, Keelung 204, Taiwan. yehccl@cgmh.org.tw.
authors.forename: Chi-Hsiao
authors.initials: CH
authors.lastname: Yeh
authors.forename: Ting-Shuo
authors.initials: TS
authors.lastname: Huang
authors.forename: Yao-Chang
authors.initials: YC
authors.lastname: Wang
authors.forename: Pin-Fu
authors.initials: PF
authors.lastname: Huang
authors.forename: Tzu-Yen
authors.initials: TY
authors.lastname: Huang
authors.forename: Tzu-Ping
authors.initials: TP
authors.lastname: Chen
authors.forename: Shun-Ying
authors.initials: SY
authors.lastname: Yin
authors.forename: Yu-Wei
authors.initials: YW
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D016208:Databases, Factual; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D057216:Propensity Score; D016016:Proportional Hazards Models; D012008:Recurrence; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan; D017131:Thrombectomy / Q000009:adverse effects; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency / Q000187:drug effects*; D055815:Young Adult
chemical_list: D010975:Platelet Aggregation Inhibitors