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Effect of cilostazol on arteriovenous fistula in hemodialysis patients.

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Title: Effect of cilostazol on arteriovenous fistula in hemodialysis patients.
Alternate Title: Efecto del cilostazol en una fístula arteriovenosa en pacientes en hemodiálisis.
Authors: Jae Wan Jeon1,2, Hae Ri Kim1,2, Eujin Lee3, Jong In Lee3, Young Rok Ham1,3, Ki Ryang Na1,3, Kang Wook Lee1,3, Jwa-Jin Kim1, Dae Eun Choi1,3 daenii@cnu.ac.kr
Source: Nefrologia. Nov/Dec2021, Vol. 41 Issue 6, p625-631. 7p.
Subjects: ARTERIAL catheterization, ARTERIOVENOUS fistula, HEMODIALYSIS patients, TRANSLUMINAL angioplasty, PERIPHERAL vascular diseases, CONTROL groups
Abstract (English): Background: The maturation and patency of permanent vascular access are critical in patients requiring hemodialysis. Although numerus trials have been attempted to achieve permanently patent vascular access, little have been noticeable. Cilostazol, a phosphodiesterase-3 inhibitor, has been shown to be effective in peripheral arterial disease including vascular injury-induced intimal hyperplasia. We therefore aimed to determine the effect of cilostazol on the patency and maturation of permanent vascular access. Methods: This single-center, retrospective study included 194 patients who underwent arteriovenous fistula surgery to compare vascular complications between the cilostazol (n = 107) and control (n = 87) groups. Results: The rate of vascular complications was lower in the cilostazol group than in the control group (36.4% vs. 51.7%; p = 0.033), including maturation failure (2.8% vs. 11.5%; p = 0.016). The rate of reoperation due to vascular injury after hemodialysis initiation following fistula maturation was also significantly lower in the cilostazol group than in the control group (7.5% vs. 28.7%; p < 0.001). However, there were no significant differences in the requirement for percutaneous transluminal angioplasty (PTA), rate of PTA, and the interval from arteriovenous fistula surgery to PTA between the cilostazol and control groups. Conclusion: Cilostazol might be beneficial for the maturation of permanent vascular access in patients requiring hemodialysis. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Antecedentes:La maduración y la permeabilidad del acceso vascular permanente son fundamentales en los pacientes que requieren hemodiálisis. Aunque se han realizado numerosos ensayos para conseguir un acceso vascular permanentemente permeable, pocos han conseguido resultados destacables. El cilostazol, un inhibidor de la fosfodiesterasa 3, ha demostrado ser eficaz en la enfermedad arterial periférica, incluida la hiperplasia intimal inducida por lesiones vasculares. Por lo tanto, nuestro objetivo era determinar el efecto del cilostazol en la permeabilidad y la maduración del acceso vascular permanente. Métodos:Este estudio unicéntrico y retrospectivo incluyó 194 pacientes sometidos a una cirugía de fístula arteriovenosa para comparar las complicaciones vasculares entre los grupos de cilostazol (n = 107) y de control (n = 87). Resultados:La tasa de complicaciones vasculares fue menor en el grupo de cilostazol que en el grupo de control (36,4% frente a 51,7%; p = 0,033), incluido el fracaso de la maduración (2,8% frente a 11,5%; p = 0,016). La tasa de reintervención por lesión vascular tras el inicio de la hemodiálisis después de la maduración de la fístula también fue significativamente menor en el grupo de cilostazol que en el grupo de control (7,5% frente a 28,7%; p < 0,001). Sin embargo, no hubo diferencias significativas en la necesidad de angioplastia transluminal percutánea (ATP), la tasa de ATP y el intervalo desde la cirugía de la fístula arteriovenosa hasta la ATP entre los grupos de cilostazol y de control. Conclusión.'El cilostazol podría ser beneficioso para la maduración del acceso vascular permanente en pacientes que necesitan hemodiálisis. [ABSTRACT FROM AUTHOR]
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Abstract:Background: The maturation and patency of permanent vascular access are critical in patients requiring hemodialysis. Although numerus trials have been attempted to achieve permanently patent vascular access, little have been noticeable. Cilostazol, a phosphodiesterase-3 inhibitor, has been shown to be effective in peripheral arterial disease including vascular injury-induced intimal hyperplasia. We therefore aimed to determine the effect of cilostazol on the patency and maturation of permanent vascular access. Methods: This single-center, retrospective study included 194 patients who underwent arteriovenous fistula surgery to compare vascular complications between the cilostazol (n = 107) and control (n = 87) groups. Results: The rate of vascular complications was lower in the cilostazol group than in the control group (36.4% vs. 51.7%; p = 0.033), including maturation failure (2.8% vs. 11.5%; p = 0.016). The rate of reoperation due to vascular injury after hemodialysis initiation following fistula maturation was also significantly lower in the cilostazol group than in the control group (7.5% vs. 28.7%; p < 0.001). However, there were no significant differences in the requirement for percutaneous transluminal angioplasty (PTA), rate of PTA, and the interval from arteriovenous fistula surgery to PTA between the cilostazol and control groups. Conclusion: Cilostazol might be beneficial for the maturation of permanent vascular access in patients requiring hemodialysis. [ABSTRACT FROM AUTHOR]
ISSN:02116995
DOI:10.1016/j.nefroe.2022.01.006