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The Impact of Transvenous Cardiac Devices on Vascular Access Patency in Hemodialysis Patients
Author(s) -
Tan Chieh Suai,
Jie Cui,
Joe Jennifer,
Irani Zubin D.,
Ganguli Suvranu,
Kalva Sanjeeva Prasad,
Wicky Stephan,
Wu Steven
Publication year - 2013
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12073
Subject(s) - medicine , vascular access , hemodialysis , hemodialysis access , surgery , psychological intervention , retrospective cohort study , psychiatry
Creating a vascular access in the presence of a cardiovascular implantable electronic device (CIED) in a patient with or approaching end‐stage renal disease can be challenging. In this study, we aimed to evaluate the impact of a CIED on the outcomes of vascular access creation in hemodialysis patients and determine their effects on vascular access patency. This is a single‐center retrospective review of hemodialysis patients who underwent vascular access creation after CIED placement. Outcomes of vascular access creation and need for endovascular interventions were compared between patients with vascular access created ipsilateral and contralateral to the site of CIED. Comparing patients with arteriovenous (AV) access created ipsilateral to CIED placement ( n = 19) versus the contralateral side ( n = 17), the primary failure rate was 78.9% versus 35.3% ( p = 0.02). For AV accesses that were matured, the median primary patency durations for AV accesses created ipsilateral to the CIED was 11.2 months compared to 7.8 months for AV accesses created contralateral to the CIED ( p = 1.00). AV accesses created ipsilateral to a CIED have a higher primary failure rate compared with the contralateral arm and should be avoided as much as possible.