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Titolo Comparison of access blood flow and venous pressure measurements as predictors of arteriovenous graft thrombosis
Autore N. Singh, S. Ahmad, J.R. Wienckowski, B.M. Murray
Referenza J Vasc Access 2006; 7: 66-73
Contenuto PURPOSE: The purpose of the present study was to prospectively compare the predictive accuracy of static venous pressure (SVP); dynamic venous pressure (DVP) and access blood flow (ABF) in determining subsequent graft thrombosis and/or failure. METHODS: This study included 43 patients with functional arteriovenous grafts (AVG\\\'s) who underwent monthly seri-al measurements of SVP, DVP and ABF for 3 consecutive months. Patients were then followed for an additional 6 months. The primary end point was graft thrombosis. RESULTS: Six patients were excluded from the final analysis. Of the 37 patients completing the study, 7 episodes of graft thrombosis occurred within 6 months of follow up. Neither SVP nor DVP exhibited satisfactory sensitivity or specificity for graft thrombosis. Ten patients either began with or developed an ABF < 600 during the 3 months of measurements, but only 5 clotted. delta ABF of >20% provided the best combination of sensitivity (86%) and specificity (90%) for graft thrombosis. In AVG\\\'s that have an ABF<600, it is those grafts with falling ABF that appear most likely to clot in the short term. CONCLUSION: The study supports the concept that it is a falling level of access flow rather than the absolute level that is the most potent predictor of graft thrombosis.
Data 15.09.2006
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