Author(s): Mohammad Mozafar, Fatemeh Hoseinzadegan, Saran Lotfollahzadeh, Maryam Baikpour, Razie Amraei, Farhad Solatpour4,Masoud Baikpour
Background: Arteriovenous fistula (AVF) is the optimal method for obtaining vascular access for dialysis. Measures such as systemic anticoagulation have been proposed as means of increasing patency rates, but not enough evidence exists to support their application. In this study, we evaluated the efficacy of preoperative heparin injection on the patency of AVF during the first 24 hours after surgery and determined whether this measure can be used to prevent early thrombosis of the vascular access. Methods: This study was conducted on 150 patients admitted to Shohada-e-Tajrish Hospital for permanent vascular access placement during 2011-2012. Seventy-five patients were randomly assigned to receive 100 units/kg of heparin intraoperatively and at 24 hours after surgery. The AVF patency rate was assessed and compared to the control group. Results: All 75 patients who received heparin intraoperatively had a patent AVF 24 hours after surgery; this showed a statistically significant difference compared to the control group, among which only 69 (92%) patients had a functioning AVF (P=0.028). Conclusion: Systemic anticoagulation with heparin can be an effective option for preventing vascular access failure. However, considering the contradictory data on the usefulness of heparin injection, larger trials are needed to evaluate efficacy and adverse effects of systemic intraoperative anticoagulation in patients with end-stage renal disease before qualifying it as a method for increasing AVF patency