title: Patient-related factors influencing patency of autogenous brachiocephalic haemodialysis fistulas.
abstract: OBJECTIVE
  The objective of this study was to analyse the outcome of autogenous brachiocephalic fistula for dialysis purposes and to determine modifiable and non-modifiable patient-related factors of influence on the patency of a newly created fistula.
  
  
  METHODS
  A single-centre retrospective cohort study with the aim of determining patient-related factors of influence on primary failure, primary, primary assisted and secondary patency of autogenous brachiocephalic fistulas. Seventeen patient-related variables were determined by means of univariate analysis, variables reaching significance were then entered in a multivariate Cox-regression model.
  
  
  RESULTS
  Between October 2005-October 2015, 231 autogenous brachiocephalic fistulas were created in 228 patients. Mean age was 61.3 years (20.3-88.2 years). Patency was calculated using Kaplan-Meier analysis. Primary failure occurred in 38 out of 231 created fistulas (16.5%). The primary, primary assisted and secondary patency rates at six months were 78 ± 3%, 93 ± 2%, and 95 ± 1%, respectively. At 12 months, they were 63 ± 3%, 89 ± 2%, and 92 ± 2%, and at 24 months 47 ± 4%, 84 ± 3%, and 89 ± 2%. The non-modifiable factors, diabetes mellitus and mean cephalic vein diameter were identified as a predictor for failure influencing primary and secondary patency. The preoperative use of anticoagulation was identified as a modifiable factor for failure.
  
  
  CONCLUSIONS
  This study identified several non-modifiable and modifiable factors of interest to the clinician deciding on which type of haemodialysis fistula is most suitable for an individual patient. Meticulous preoperative work-up, a surveillance programme, and a dedicated multidisciplinary team can be of great importance in achieving better patency rates.
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University Medical Centre Groningen, University of Groningen, Groningen - The Netherlands.
authors.forename: Alexander
authors.initials: A
authors.lastname: Lamprou
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University Medical Centre Groningen, University of Groningen, Groningen - The Netherlands.
authors.forename: Cor
authors.initials: C
authors.lastname: de Bruin
authors.affiliation: Department of Internal Medicine, Division of Vascular Medicine, University Medical Centre Groningen, University of Groningen, Groningen - The Netherlands.
authors.forename: Arie
authors.initials: A
authors.lastname: van Roon
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University Medical Centre Groningen, University of Groningen, Groningen - The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Loonstra
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University Medical Centre Groningen, University of Groningen, Groningen - The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: van der Laan
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University Medical Centre Groningen, University of Groningen, Groningen - The Netherlands.
authors.forename: Ignace
authors.initials: I
authors.lastname: Tielliu
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University Medical Centre Groningen, University of Groningen, Groningen - The Netherlands.
authors.forename: Clark
authors.initials: C
authors.lastname: Zeebregts
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000379:methods*; D001916:Brachial Artery / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D014654:Vascular Patency; D014680:Veins / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult