VASCULAR ACCESSES ON OCTOGENARIAN PATIENTS
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.48750/acv.48 |
Resumo: | Introduction: The vascular access used in hemodialysis patients with chronic renal disease include the arteriovenous fistulae (AVF) (proximal and distal), grafts and central venous catheters. It is a question of debate if there is an advantage or indication to obtain definitive vascular access in patients with advanced age, especially over 80 years. The aim of the article focuses on demonstrating the feasibility and advantages of autologous accesses on octogenarian patients. Material and Methods: Retrospective analysis of electronic records of patients undergoing vascular access (AVF proximal, distal and grafts), aged> 79 years. The time period was evaluated from 01/01/2010 to 31/12/2015. Results: The sample of six years includes 21 patients. Of the sample, 52% are male and 48% female. The age distribution shows 10 patients (82-84), 5 patients (79-81), 5 patients (85-88) and 1 patient (89-90) years. The analysis of the presence of the cardiovascular risk factors (RF) (diabetes mellitus, smoking and dyslipidemia), of which 35%: 2 RF; 24%: 3RF; 23%: 1RF; 12% none of the considered. Of the total sample, 67% had diabetes mellitus (57% non-insulin-treated and 43% insulin-treated). The evaluation of the functional status of the sample using the Katz scale, showed 3 patients with score 0, 9 patients with score 1, 5 patients with score 2, 2 patients with score 3 and 2 patients with score 4. For the location of the access, 40% distal AVF, 35% proximal AVF and 25% grafts. All patients were first tested with Doppler ultrasound for anatomic definition. From all surgeries, 19% of patients (4 in total) required a new more proximal access. It stands out as complications, one hematoma and two surgical infections. Conclusion: This study proved that is possible to achieve permanent vascular access (fistula or graft) in octogenarian patients starting dialysis, and that the functional status is a more important determinant than the chronological age" It is recommended an individualized approach, with more liberal use of proximal or prosthetic access, given the shorter life expectancy of patients. |
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VASCULAR ACCESSES ON OCTOGENARIAN PATIENTSACESSOS VASCULARES NOS OCTAGENÁRIOSFistulas arterio-venosasoctagenáriosacesso autólogoarteriovenous fistulaeoctogenarianautologous accessIntroduction: The vascular access used in hemodialysis patients with chronic renal disease include the arteriovenous fistulae (AVF) (proximal and distal), grafts and central venous catheters. It is a question of debate if there is an advantage or indication to obtain definitive vascular access in patients with advanced age, especially over 80 years. The aim of the article focuses on demonstrating the feasibility and advantages of autologous accesses on octogenarian patients. Material and Methods: Retrospective analysis of electronic records of patients undergoing vascular access (AVF proximal, distal and grafts), aged> 79 years. The time period was evaluated from 01/01/2010 to 31/12/2015. Results: The sample of six years includes 21 patients. Of the sample, 52% are male and 48% female. The age distribution shows 10 patients (82-84), 5 patients (79-81), 5 patients (85-88) and 1 patient (89-90) years. The analysis of the presence of the cardiovascular risk factors (RF) (diabetes mellitus, smoking and dyslipidemia), of which 35%: 2 RF; 24%: 3RF; 23%: 1RF; 12% none of the considered. Of the total sample, 67% had diabetes mellitus (57% non-insulin-treated and 43% insulin-treated). The evaluation of the functional status of the sample using the Katz scale, showed 3 patients with score 0, 9 patients with score 1, 5 patients with score 2, 2 patients with score 3 and 2 patients with score 4. For the location of the access, 40% distal AVF, 35% proximal AVF and 25% grafts. All patients were first tested with Doppler ultrasound for anatomic definition. From all surgeries, 19% of patients (4 in total) required a new more proximal access. It stands out as complications, one hematoma and two surgical infections. Conclusion: This study proved that is possible to achieve permanent vascular access (fistula or graft) in octogenarian patients starting dialysis, and that the functional status is a more important determinant than the chronological age" It is recommended an individualized approach, with more liberal use of proximal or prosthetic access, given the shorter life expectancy of patients. Introdução: Os acessos vasculares utilizados na hemodiálise em doentes com doença renal crónica terminal englobam as fístulas arterio-venosas (FAV) (proximais e distais), enxertos e os catéteres venosos centrais. Questiona-se se há vantagem e ou indicação para a obtenção de acesso vascular definitivo em doentes com idades mais avançadas, particularmente acima dos 80 anos. O objectivo do trabalho centra-se em demonstrar a exequibilidade e as vantagens dos acessos autólogos em doentes octagenários. Material e Método: Análise retrospectiva de processos electrónicos dos doentes submetidos a realização de acesso vascular (FAV proximais, distais e enxertos), com idades > 79 anos. O período de tempo avaliado foi 01/01/2010 a 31/12/2015. Resultados: A casuística dos 6 anos engloba 21 doentes. Da amostra, 52% são do sexo masculino e 48% do sexo feminino. A distribuição etária revela 10 doentes (82-84), 5 doentes (79-81), 5 doentes (85-88) e 1 doente (89-90) anos. Analisa-se a presença de factores de risco (FR) cardiovasculares (diabetes mellitus, dislipidémia e tabagismo), dos quais 35%: 2 FR, 24%: 3 FR, 23%: 1 FR e 12% nenhum dos considerados. Da amostra total, 67% apresentam diabetes mellitus, (57% não insulino-tratada e 43% insulino-tratada). Avalia-se o grau funcional da amostra utilizando a escala Katz, revelando 3 doentes com score 0, 9 doentes com score 1, 5 doentes com grau 2, 2 doentes com score 3 e 2 doentes com score 4. Relativamente à localização dos acessos, 40% FAVs distais, 35% FAVs proximais e 25% enxertos. Todos os doentes foram previamente estudados com ecodoppler para definição anatómica. Do total de cirurgias, 19% dos doentes (4 no total) necessitaram de um novo acesso mais proximal. Destacam-se como complicações 1 hematoma e 2 infecções da ferida operatória. Conclusão: Este estudo demonstrou ser possivel realizar acesso vascular definitivo (fistula ou enxerto) em doentes octagenarios que iniciam dialise, sendo o status funcional um fator condicionante mais importante que propriamente a idade cronologica. Recomenda-se uma abordagem individualizada, com recurso mais liberal a acessos mais proximais ou mesmo protésicos, dada a menor esperança de vida dos doentes. Sociedade Portuguesa de Angiologia e Cirurgia Vascular2017-05-14T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48750/acv.48oai:ojs.acvjournal.com:article/48Angiologia e Cirurgia Vascular; Vol. 13 No. 1 (2017): March; 24-29Angiologia e Cirurgia Vascular; Vol. 13 N.º 1 (2017): Março; 24-292183-00961646-706Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://acvjournal.com/index.php/acv/article/view/48https://doi.org/10.48750/acv.48http://acvjournal.com/index.php/acv/article/view/48/37Copyright (c) 2017 Angiologia e Cirurgia Vascularinfo:eu-repo/semantics/openAccessReia, MartaAfonso, AnaGonzalez, AntónioGonçalves, AnaFerreira, Maria José2022-05-23T15:09:59Zoai:ojs.acvjournal.com:article/48Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T14:57:27.792392Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
VASCULAR ACCESSES ON OCTOGENARIAN PATIENTS ACESSOS VASCULARES NOS OCTAGENÁRIOS |
title |
VASCULAR ACCESSES ON OCTOGENARIAN PATIENTS |
spellingShingle |
VASCULAR ACCESSES ON OCTOGENARIAN PATIENTS Reia, Marta Fistulas arterio-venosas octagenários acesso autólogo arteriovenous fistulae octogenarian autologous access |
title_short |
VASCULAR ACCESSES ON OCTOGENARIAN PATIENTS |
title_full |
VASCULAR ACCESSES ON OCTOGENARIAN PATIENTS |
title_fullStr |
VASCULAR ACCESSES ON OCTOGENARIAN PATIENTS |
title_full_unstemmed |
VASCULAR ACCESSES ON OCTOGENARIAN PATIENTS |
title_sort |
VASCULAR ACCESSES ON OCTOGENARIAN PATIENTS |
author |
Reia, Marta |
author_facet |
Reia, Marta Afonso, Ana Gonzalez, António Gonçalves, Ana Ferreira, Maria José |
author_role |
author |
author2 |
Afonso, Ana Gonzalez, António Gonçalves, Ana Ferreira, Maria José |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Reia, Marta Afonso, Ana Gonzalez, António Gonçalves, Ana Ferreira, Maria José |
dc.subject.por.fl_str_mv |
Fistulas arterio-venosas octagenários acesso autólogo arteriovenous fistulae octogenarian autologous access |
topic |
Fistulas arterio-venosas octagenários acesso autólogo arteriovenous fistulae octogenarian autologous access |
description |
Introduction: The vascular access used in hemodialysis patients with chronic renal disease include the arteriovenous fistulae (AVF) (proximal and distal), grafts and central venous catheters. It is a question of debate if there is an advantage or indication to obtain definitive vascular access in patients with advanced age, especially over 80 years. The aim of the article focuses on demonstrating the feasibility and advantages of autologous accesses on octogenarian patients. Material and Methods: Retrospective analysis of electronic records of patients undergoing vascular access (AVF proximal, distal and grafts), aged> 79 years. The time period was evaluated from 01/01/2010 to 31/12/2015. Results: The sample of six years includes 21 patients. Of the sample, 52% are male and 48% female. The age distribution shows 10 patients (82-84), 5 patients (79-81), 5 patients (85-88) and 1 patient (89-90) years. The analysis of the presence of the cardiovascular risk factors (RF) (diabetes mellitus, smoking and dyslipidemia), of which 35%: 2 RF; 24%: 3RF; 23%: 1RF; 12% none of the considered. Of the total sample, 67% had diabetes mellitus (57% non-insulin-treated and 43% insulin-treated). The evaluation of the functional status of the sample using the Katz scale, showed 3 patients with score 0, 9 patients with score 1, 5 patients with score 2, 2 patients with score 3 and 2 patients with score 4. For the location of the access, 40% distal AVF, 35% proximal AVF and 25% grafts. All patients were first tested with Doppler ultrasound for anatomic definition. From all surgeries, 19% of patients (4 in total) required a new more proximal access. It stands out as complications, one hematoma and two surgical infections. Conclusion: This study proved that is possible to achieve permanent vascular access (fistula or graft) in octogenarian patients starting dialysis, and that the functional status is a more important determinant than the chronological age" It is recommended an individualized approach, with more liberal use of proximal or prosthetic access, given the shorter life expectancy of patients. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-05-14T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.48750/acv.48 oai:ojs.acvjournal.com:article/48 |
url |
https://doi.org/10.48750/acv.48 |
identifier_str_mv |
oai:ojs.acvjournal.com:article/48 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://acvjournal.com/index.php/acv/article/view/48 https://doi.org/10.48750/acv.48 http://acvjournal.com/index.php/acv/article/view/48/37 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Angiologia e Cirurgia Vascular info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Angiologia e Cirurgia Vascular |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
dc.source.none.fl_str_mv |
Angiologia e Cirurgia Vascular; Vol. 13 No. 1 (2017): March; 24-29 Angiologia e Cirurgia Vascular; Vol. 13 N.º 1 (2017): Março; 24-29 2183-0096 1646-706X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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