The arteriovenous access stage (AVAS) classification

被引:5
作者
Balaz, Peter [1 ,2 ]
Hanko, Jennifer [3 ,4 ]
Magowan, Hannah [3 ,4 ]
Masengu, Agnes [3 ,4 ]
Lawrie, Katarina [1 ]
O'Neill, Stephen [3 ,4 ]
机构
[1] Charles Univ Prague, Fac Hosp Kralovske Vinohrady, Fac Med 3, Dept Surg, Prague, Czech Republic
[2] Natl Inst Cardiovasc Dis, Dept Vasc Surg, Bratislava, Slovakia
[3] Belfast City Hosp, Dept Transplant Surg, Belfast, Antrim, North Ireland
[4] Belfast City Hosp, Reg Nephrol Unit, Belfast, Antrim, North Ireland
关键词
arteriovenous fistula; arteriovenous graft; classification; haemodialysis; vascular access; VASCULAR ACCESS; HEMODIALYSIS; FISTULA; MAINTENANCE; PLACEMENT; FAILURE; PATENCY; VEIN;
D O I
10.1093/ckj/sfaa189
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: Key anatomical factors mean that individuals needing arteriovenous access are unique and have different possibilities for fistula creation. The aim of this article is to describe a new classification system for all patients needing haemodialysis vascular access in the upper extremity with the purpose to simplify sharing the information about suitability for surgical access creation depending on vascular anatomy. Methods: According to the patient's vascular anatomy in right and left superior extremities, patients were separated into three arteriovenous access stages (AVAS). The AVAS was validated by three blinded observers using a sample of 70 upper limb arteriovenous maps that were performed using ultrasound on patients referred for vascular access assessment. A sample size calculation was performed and calculated that for three observers, a minimum of 67 maps were required to confirm significant agreement at a Kappa value of 0.9 (95% confidence interval 0.75-0.99). Results: The Kappa value for inter-rater reliability using Fleiss' Kappa coefficient was 0.94 and all patients fitted into the AVAS classification system. Conclusion: The AVAS classification system is a simplified way to share information about vascular access options based on a patient's vascular anatomy with high inter-rater reliability.
引用
收藏
页码:1747 / 1751
页数:5
相关论文
共 22 条
[1]   Innovations in vascular access for hemodialysis [J].
Agarwal, Anil K. ;
Haddad, Nabil J. ;
Vachharajani, Tushar J. ;
Asif, Arif .
KIDNEY INTERNATIONAL, 2019, 95 (05) :1053-1063
[2]   A Review on the Hemodialysis Reliable Outflow (HeRO) Graft for Haemodialysis Vascular Access [J].
Al Shakarchi, J. ;
Houston, J. G. ;
Jones, R. G. ;
Inston, N. .
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2015, 50 (01) :108-113
[3]   End-stage vascular access failure: can we define and can we classify? [J].
Al Shakarchi, Julien ;
Nath, Jay ;
McGrogan, Damian ;
Khawaja, Aurangzaib ;
Field, Melanie ;
Jones, Robert G. ;
Inston, Nicholas .
CLINICAL KIDNEY JOURNAL, 2015, 8 (05) :590-593
[4]   Utilization, patency, and complications associated with vascular access for hemodialysis in the United States [J].
Arhuidese, Isibor J. ;
Orandi, Babak J. ;
Nejim, Besma ;
Malas, Mahmoud .
JOURNAL OF VASCULAR SURGERY, 2018, 68 (04) :1166-1174
[5]   Vascular access conversion and patient outcome after hemodialysis initiation with a nonfunctional arteriovenous access: a prospective registry-based study [J].
de Pinho, Natalia Alencar ;
Coscas, Raphael ;
Metzger, Marie ;
Labeeuw, Michel ;
Ayav, Carole ;
Jacquelinet, Christian ;
Massy, Ziad A. ;
Stengel, Benedicte .
BMC NEPHROLOGY, 2017, 18 :1-11
[6]  
Dorobantu L F, 2006, J Vasc Access, V7, P87
[7]   The Necessity for Routine Pre-operative Ultrasound Mapping Before Arteriovenous Fistula Creation: A Meta-analysis [J].
Georgiadis, G. S. ;
Charalampidis, D. G. ;
Argyriou, C. ;
Georgakarakos, E. I. ;
Lazarides, M. K. .
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2015, 49 (05) :600-605
[8]   PROXIMAL FOREARM FISTULA FOR MAINTENANCE HEMODIALYSIS [J].
GRACZ, KC ;
ING, TS ;
SOUNG, LS ;
ARMBRUSTER, KFW ;
SEIM, SK ;
MERKEL, FK .
KIDNEY INTERNATIONAL, 1977, 11 (01) :71-74
[9]   Arteriovenous Fistula Placement in the Elderly: When Is the Optimal Time? [J].
Hod, Tammy ;
Patibandla, Bhanu K. ;
Vin, Yael ;
Brown, Robert S. ;
Goldfarb-Rumyantzev, Alexander S. .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2015, 26 (02) :448-456
[10]   Factors predicting failure of AV "fistula first" policy in the elderly [J].
Hod, Tammy ;
DeSilva, Ranil N. ;
Patibandla, Bhanu K. ;
Vin, Yael ;
Brown, Robert S. ;
Goldfarb-Rumyantzev, Alexander S. .
HEMODIALYSIS INTERNATIONAL, 2014, 18 (02) :507-515