Abstract
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:
This review aims to establish efficacy and safety of interventions for failed HD fistulas and AVG in HD patients.
Background
Description of the condition
Kidney dysfunction is the inability of the kidney to filter waste in the blood. Chronic kidney disease (CKD) is a silent disease, which leads to an imbalance that can cause severe damage to health (Sesso 2011). When CKD progresses to end‐stage kidney disease (ESKD), dialysis or kidney transplantation are the only available treatments (USRDS 2017). Dialysis prolongs the survival of chronic uraemic patients (USRDS 2017).
The prevalence of kidney dysfunction (of any degree) varies from 8% to 22.7%, resulting in clinical procedures, such as haemodialysis (HD) (Anonymous 2013; EROCAP 2007; USRDS 2017). The incidence and prevalence of dialysis are increasing (USRDS 2017). The population is aging and several significant comorbidities, such as diabetes, arterial hypertension and arteriopathies coexist with CKD (Anonymous 2013).
In the USA, 80% of patients with CKD begin treatment with a HD catheter, while only 16.9% use it by arteriovenous fistula (AVF), and 3% by arteriovenous graft (AVG) (USRDS 2017). At the end of 2014, the prevalence of AVF was 63.4% in dialysis patients (USRDS 2017). Patency data in the literature are scarce and they are reported to be around 64% in one year in patients with AVF without any intervention, improving to 73% if those cases were primarily assisted (Bylsma 2017; Lee 2017; Rooijens 2004).
It is necessary to have adequate access for successful HD; the absence of access or distal thrombosis with increased resistance may prevent successful HD (KDOQI 2006). Patients who present with problems with definitive dialysis access (AVF or AVG) become catheter‐dependent (temporary access), which often carries a higher risk of infections, central venous occlusions, and recurrent hospitalisations (KDOQI 2006; Sesso 2014).
Description of the intervention
Stenosis can lead to access thrombosis, but there are other causes of thrombosis, such as low flow because of hypotension or low cardiac output (KDOQI 2006; USRDS 2017). Stenosis is defined as an increase in lumen reduction of over 50% compared to adjacent regions; this stenosis usually occurs owing to severe local fibrosis (Katsanos 2012).The thrombus should be removed to ensure HD access (EROCAP 2007). Subsequently, after removal of the thrombus, the stenosis should be treated to avoid early re‐occlusion (Kuhan 2013).
There are several procedures for treating the AVF/AVG thrombosis.
Thrombectomy with Fogarty catheter is a surgical procedure, which is aimed at mechanically removing the thrombus and re‐establishing the blood flow (KDOQI 2006; Uflacker 2004). The Fogarty catheter consists of an inflatable balloon at its tip. The balloon is inflated after passing the region of the thrombus and extracting it (Uflacker 2004).
Thrombolysis is another treatment option in acute HD vascular access occlusions (Schuman 1994). Thrombolysis involves using medication that degrades the clot and thereby restores blood flow (Schuman 1994).
Thrombolysis therapy involves the use of a few devices, such as Aspirex® and AngioJet® (Hongsakul 2015; KDOQI 2006), both promote the dissolution of thrombus and its consequent aspiration mechanically via a hydrodynamic system or by simple thrombus aspiration (Barth 2000; Uflacker 2004).
How the intervention might work
For AVG, primary patency rates are reported to be 30% to 90% in patients undergoing thrombectomy or thrombolysis (Barth 2000; Hongsakul 2015, Uflacker 2004). However, Barth 2000 found that thrombectomy is performed faster than thrombolysis, and the overall complication rates are about 6% to 22%, with embolization being the most common.
Moreover, Green 2002 showed that surgical thrombectomy had a superior patency rate, with lower complication rate, for the treatment of thrombosed prosthetic vascular access grafts.
Schuman 1994 showed that thrombectomy therapy in AVG has patency rates of around 60%. In the same study, overall complication rates (bleeding, hematoma, and blood dyscrasias) were around 6% for this therapy.
Although primary and secondary patency rates are lower in endovascular therapies compared to thrombectomy (50% versus 70% to 80%), both procedures have approximately the same success rates on de‐clotting an AVF (90%) (Tordoir 2009).
Why it is important to do this review
Patients undergoing fistula salvage have the advantage of prolonged survival and subsequent improvement in the quality of life when compared to patients using HD catheter (USRDS 2017). In contrast, those procedures increase the risk of bleeding, recoil, rupture of access, and acute thrombosis (Sesso 2014).
Interventions for the salvage of thrombosed fistulas are based on mechanical or pharmacological removal of the thrombus to restore blood flow. The most frequently used interventions are surgical thrombectomy and pharmacomechanical thrombolysis (Uflacker 2004).
The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines emphasised the importance of a systematic review and other trials for failed AVF (KDOQI 2006; Kuhan 2013). Tordoir 2009 highlighted the importance of randomised controlled trials (RCTs) to address the question on interventions for failed HD fistulas and AVG. In addition, surgical treatment of AVF is likely to have benefits when compared with endovascular methods in primary success rates (Tordoir 2009).The most effective method to ensure patency is not yet known (Kuhan 2013).
According to the National Kidney Foundation‐Kidney Disease Outcomes Quality Initiative (NKF‐KDOQI) guidelines, surgery is preferred when the cause of the thrombosis is a stenosis at the site of anastomosis in thrombosed AVFs (Cho 2017; KDOQI 2006).
The European Best Practice Guidelines (EBPG) reported that thrombosed AVF may preferably be treated with endovascular techniques, but when the cause of thrombosis is in the anastomosis, surgery provides better results with re‐anastomosis (Ponikvar 2009; Tordoir 2007).
Therefore, there is a need to carry out a systematic review to determine the effectiveness and safety of the intervention for thrombosed fistulas.
Objectives
This review aims to establish efficacy and safety of interventions for failed HD fistulas and AVG in HD patients.
Methods
Criteria for considering studies for this review
Types of studies
We will include RCTs or ‐ if there only a few RCTs ‐ quasi‐RCTs (RCTs in which allocation to treatment was obtained by alternation, use of alternate medical records, date of birth or other predictable methods) that compare interventions in people with failed HD fistulas or AVG.
Types of participants
Inclusion criteria
We will include all patients (adults and children) undergoing chronic HD treatment using AVF or AVG presenting with clinical or haemodynamic evidence of thrombosis. Patients will have used the AVF or AVG at least one time. Clinical dysfunction during dialysis will be defined as absence of pulse or thrill (Barth 2000). Haemodynamic evidence will be defined as an absence of flow measured by Doppler ultrasound (Aftab 2014; Tessitore 2013).
Exclusion criteria
Patient will be excluded if they have an occluded AVF or AVG occluded for more than 14 days, or are treated directly with interposition or bypass. Patients will also be excluded if they have contrast allergy, urokinase allergy, bleeding diatheses and graft infection. Patients who have an immature fistula, in which the venous limb of the fistula has failed to dilate and remains uniformly attenuated, will also be excluded.
Types of interventions
All techniques aimed at revascularization in failed HD fistulas or AVG, including but not confined to:
Surgical thrombectomy
Thrombolytic therapy
Mechanical thrombolysis
Pharmacomechanical thrombolysis.
We will also include RCTs comparing one intervention alone or combined to adjunctive post‐intervention such as thrombectomy. Combined interventions may mask some outcome, therefore, we may perform subgroup analysis.
Types of outcome measures
The outcomes selected include the HD SONG core outcome set as specified by the Standardised Outcomes in Nephrology initiative (SONG 2017). HD success will be assessed using SONG criteria (Figure 1).
Figure 1.
Outcome measures for SONG‐HD Vascular Access (SONG 2017)
Primary outcomes
Failure: defined as the inability to perform at least one successful dialysis procedure following procedure
Patency at 30 days: defined as successful dialysis at the 30‐day follow‐up period without secondary intervention.
Secondary outcomes
Death: any death that occurred within 30 days of treatment
Technical success: defined as less than 30% residual thrombus judged by the difference between the initial and the final venograms
Access dysfunction: defined as reduction of flow rate or total loss of flow.
Successful dialysis: SONG criteria or clinical criteria such as: duration of dialysis achieved; adequate removal of fluid and/or adequate changes in biochemistry (SONG 2017).
-
Major adverse events
Arterial embolism
Thromboembolic complications (deep venous thrombosis and pulmonary embolism as defined by the authors of primary studies)
Pseudoaneurysm formation
Perforation of the graft or draining vein
Cardiovascular disease
-
Minor adverse events
Blood loss
Arm swelling
Prolonged bleeding from puncture sites
Fatigue.
Search methods for identification of studies
Electronic searches
We will search the Cochrane Kidney and Transplant Register of Studies through contact with the Information Specialist using search terms relevant to this review. The Register contains studies identified from the following sources:
Monthly searches of the Cochrane Central Register of Controlled Trials (CENTRAL)
Weekly searches of MEDLINE OVID SP
Handsearching of kidney‐related journals and the proceedings of major kidney and transplant conferences
Searching of the current year of EMBASE OVID SP
Weekly current awareness alerts for selected kidney and transplant journals
Searches of the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov.
Studies contained in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE based on the scope of Cochrane Kidney and Transplant. Details of search strategies, as well as a list of handsearched journals, conference proceedings and current awareness alerts, are available in the Specialised Register section of information about Cochrane Kidney and Transplant.
See Appendix 1 for search terms used in strategies for this review.
Searching other resources
Reference lists of review articles, relevant studies and clinical practice guidelines.
Letters seeking information about unpublished or incomplete studies to investigators known to be involved in previous studies.
Data collection and analysis
Selection of studies
The search strategy described will be used to obtain titles and abstracts of studies that may be relevant to the review. The titles and abstracts will be screened independently by two authors, who will discard studies that are not applicable, however studies and reviews that might include relevant data or information on studies will be retained initially. Two authors will independently assess retrieved abstracts and, if necessary, the full text of these studies to determine which studies satisfy the inclusion criteria. We will resolve any disagreements through discussion or, if required, we will consult a third review author. We will collate multiple reports of the same study so that each study, not each reference, is the unit of interest in the review. We will record the selection process and complete a PRISMA flow diagram.
Data extraction and management
Data extraction will be carried out independently by two authors using standard data extraction forms. Studies reported in non‐English language journals will be translated before assessment. Where more than one publication of one study exists, reports will be grouped together and the publication with the most complete data will be used in the analysis. Data will be used where relevant outcomes are only published in earlier versions. Any discrepancy between published versions will be highlighted.
Assessment of risk of bias in included studies
The following items will be independently assessed by two authors using the risk of bias assessment tool (Higgins 2011) (see Appendix 2).
Was there adequate sequence generation (selection bias)?
Was allocation adequately concealed (selection bias)?
-
Was knowledge of the allocated interventions adequately prevented during the study?
Participants and personnel (performance bias)
Outcome assessors (detection bias)
Were incomplete outcome data adequately addressed (attrition bias)?
Are reports of the study free of suggestion of selective outcome reporting (reporting bias)?
Was the study apparently free of other problems that could put it at a risk of bias?
We will grade the risk of bias for each domain as high, low or unclear and provide information from the study report together with a justification for our judgment in the 'Risk of bias' tables.
Measures of treatment effect
For dichotomous variables, we will calculate the risk ratio (RR) and 95% confidence interval (CI). For continuous data, we will calculate the mean difference (MD) and 95% CI between treatment groups if studies report exactly the same outcomes. If similar outcomes are reported on different scales, we will calculate the standardised mean difference (SMD) and 95% CI. The most appropriate way of summarizing time‐to‐event data is to use methods of survival analysis and to express the intervention effect as a hazard ratio, and these data will be taken directly from the results of the studies (Higgins 2011).
Unit of analysis issues
We will base the unit of analysis on the individual participant (unit to be randomised for interventions to be compared), i.e. the number of observations in the analysis should match the number of individuals randomised.
Dealing with missing data
Any further information required from the original author will be requested by written correspondence (e.g. emailing corresponding author) and any relevant information obtained in this manner will be included in the review. Evaluation of important numerical data such as screened, randomised patients as well as intention‐to‐treat, as‐treated and per‐protocol population will be carefully performed. Attrition rates, for example drop‐outs, losses to follow‐up and withdrawals will be investigated. Issues of missing data and imputation methods (for example, last‐observation‐carried‐forward) will be critically appraised (Higgins 2011).
Assessment of heterogeneity
We will first assess the heterogeneity by visual inspection of the forest plot. We will quantify statistical heterogeneity using the I² statistic, which describes the percentage of total variation across studies that is due to heterogeneity rather than sampling error (Higgins 2003). A guide to the interpretation of I² values will be as follows.
0% to 40%: might not be important
30% to 60%: may represent moderate heterogeneity
50% to 90%: may represent substantial heterogeneity
75% to 100%: considerable heterogeneity.
The importance of the observed value of I² depends on the magnitude and direction of treatment effects and the strength of evidence for heterogeneity (e.g. P‐value from the Chi² test, or a confidence interval for I²) (Higgins 2011).
Assessment of reporting biases
If possible, funnel plots will be used to assess for the potential existence of small study bias (Higgins 2011).
Data synthesis
Data will be pooled using the random‐effects model but the fixed‐effect model will also be used to ensure robustness of the model chosen and susceptibility to outliers.
Subgroup analysis and investigation of heterogeneity
Subgroup analysis will be used to explore possible sources of heterogeneity. Subgroup analyses of the primary outcomes were to include fistulas versus AVG, by heterogeneity of study quality. Heterogeneity among participants could be related to age and renal pathology (gender, ethnicity, diabetics versus non‐diabetics, vascular disease, BMI, age category, previous use of catheters). Heterogeneity in treatments could be related to prior agent(s) used and the agent, dose and duration of therapy. Statistical heterogeneity in study design and risk of bias were evaluated. Adverse effects will be tabulated and assessed with descriptive techniques, as they are likely to be different for the various agents used. Where possible, the risk difference with 95% CI will be calculated for each adverse effect, either compared to no treatment or to another agent. Subgroup analysis could include location of AV access and type – forearm versus upper arm; radiocephalic versus brachiocephalic versus transposed basilic. If there is enough data we will consider different types of AVG – PTFE versus heparin, bonded versus immediate use (early cannulation) AV grafts.
Sensitivity analysis
We will perform sensitivity analyses in order to explore the influence of the following factors on effect size.
Repeating the analysis excluding unpublished studies
Repeating the analysis taking account of risk of bias, as specified
Repeating the analysis excluding any very long or large studies to establish how much they dominate the results
Repeating the analysis excluding studies using the following filters: diagnostic criteria, language of publication, source of funding (industry versus other), and country.
'Summary of findings' tables
We will present the main results of the review in 'Summary of findings' tables. These tables present key information concerning the quality of the evidence, the magnitude of the effects of the interventions examined, and the sum of the available data for the main outcomes (Schünemann 2011a). The 'Summary of findings' tables also include an overall grading of the evidence related to each of the main outcomes using the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach (GRADE 2008; GRADE 2011). The GRADE approach defines the quality of a body of evidence as the extent to which one can be confident that an estimate of effect or association is close to the true quantity of specific interest. The quality of a body of evidence involves consideration of within‐trial risk of bias (methodological quality), directness of evidence, heterogeneity, precision of effect estimates and risk of publication bias (Schünemann 2011b). We plan to present the following outcomes in the 'Summary of findings' tables.
Failure
Primary patency at 30 days
Death
Technical success
Access dysfunction
Successful dialysis: SONG criteria
Major adverse events (e.g. arterial embolism, thromboembolic complications, pseudoaneurysm formation, perforation of the graft or draining vein, cardiovascular disease)
Minor adverse events (e.g. blood loss, arm swelling, prolonged bleeding from puncture sites, fatigue).
Acknowledgements
We wish to thank the editorial group for their comments, especially Dr Fiona Russell for her support during the preparation of this protocol.
Appendices
Appendix 1. Electronic search strategies
| Database | Search terms |
| CENTRAL |
|
| MEDLINE |
|
| EMBASE |
|
Appendix 2. Risk of bias assessment tool
| Potential source of bias | Assessment criteria |
|
Random sequence generation Selection bias (biased allocation to interventions) due to inadequate generation of a randomised sequence |
Low risk of bias: Random number table; computer random number generator; coin tossing; shuffling cards or envelopes; throwing dice; drawing of lots; minimisation (minimisation may be implemented without a random element, and this is considered to be equivalent to being random). |
| High risk of bias: Sequence generated by odd or even date of birth; date (or day) of admission; sequence generated by hospital or clinic record number; allocation by judgement of the clinician; by preference of the participant; based on the results of a laboratory test or a series of tests; by availability of the intervention. | |
| Unclear: Insufficient information about the sequence generation process to permit judgement. | |
|
Allocation concealment Selection bias (biased allocation to interventions) due to inadequate concealment of allocations prior to assignment |
Low risk of bias: Randomisation method described that would not allow investigator/participant to know or influence intervention group before eligible participant entered in the study (e.g. central allocation, including telephone, web‐based, and pharmacy‐controlled, randomisation; sequentially numbered drug containers of identical appearance; sequentially numbered, opaque, sealed envelopes). |
| High risk of bias: Using an open random allocation schedule (e.g. a list of random numbers); assignment envelopes were used without appropriate safeguards (e.g. if envelopes were unsealed or non‐opaque or not sequentially numbered); alternation or rotation; date of birth; case record number; any other explicitly unconcealed procedure. | |
| Unclear: Randomisation stated but no information on method used is available. | |
|
Blinding of participants and personnel Performance bias due to knowledge of the allocated interventions by participants and personnel during the study |
Low risk of bias: No blinding or incomplete blinding, but the review authors judge that the outcome is not likely to be influenced by lack of blinding; blinding of participants and key study personnel ensured, and unlikely that the blinding could have been broken. |
| High risk of bias: No blinding or incomplete blinding, and the outcome is likely to be influenced by lack of blinding; blinding of key study participants and personnel attempted, but likely that the blinding could have been broken, and the outcome is likely to be influenced by lack of blinding. | |
| Unclear: Insufficient information to permit judgement | |
|
Blinding of outcome assessment Detection bias due to knowledge of the allocated interventions by outcome assessors. |
Low risk of bias: No blinding of outcome assessment, but the review authors judge that the outcome measurement is not likely to be influenced by lack of blinding; blinding of outcome assessment ensured, and unlikely that the blinding could have been broken. |
| High risk of bias: No blinding of outcome assessment, and the outcome measurement is likely to be influenced by lack of blinding; blinding of outcome assessment, but likely that the blinding could have been broken, and the outcome measurement is likely to be influenced by lack of blinding. | |
| Unclear: Insufficient information to permit judgement | |
|
Incomplete outcome data Attrition bias due to amount, nature or handling of incomplete outcome data. |
Low risk of bias: No missing outcome data; reasons for missing outcome data unlikely to be related to true outcome (for survival data, censoring unlikely to be introducing bias); missing outcome data balanced in numbers across intervention groups, with similar reasons for missing data across groups; for dichotomous outcome data, the proportion of missing outcomes compared with observed event risk not enough to have a clinically relevant impact on the intervention effect estimate; for continuous outcome data, plausible effect size (difference in means or standardised difference in means) among missing outcomes not enough to have a clinically relevant impact on observed effect size; missing data have been imputed using appropriate methods. |
| High risk of bias: Reason for missing outcome data likely to be related to true outcome, with either imbalance in numbers or reasons for missing data across intervention groups; for dichotomous outcome data, the proportion of missing outcomes compared with observed event risk enough to induce clinically relevant bias in intervention effect estimate; for continuous outcome data, plausible effect size (difference in means or standardized difference in means) among missing outcomes enough to induce clinically relevant bias in observed effect size; ‘as‐treated’ analysis done with substantial departure of the intervention received from that assigned at randomisation; potentially inappropriate application of simple imputation. | |
| Unclear: Insufficient information to permit judgement | |
|
Selective reporting Reporting bias due to selective outcome reporting |
Low risk of bias: The study protocol is available and all of the study’s pre‐specified (primary and secondary) outcomes that are of interest in the review have been reported in the pre‐specified way; the study protocol is not available but it is clear that the published reports include all expected outcomes, including those that were pre‐specified (convincing text of this nature may be uncommon). |
| High risk of bias: Not all of the study’s pre‐specified primary outcomes have been reported; one or more primary outcomes is reported using measurements, analysis methods or subsets of the data (e.g. sub‐scales) that were not pre‐specified; one or more reported primary outcomes were not pre‐specified (unless clear justification for their reporting is provided, such as an unexpected adverse effect); one or more outcomes of interest in the review are reported incompletely so that they cannot be entered in a meta‐analysis; the study report fails to include results for a key outcome that would be expected to have been reported for such a study. | |
| Unclear: Insufficient information to permit judgement | |
|
Other bias Bias due to problems not covered elsewhere in the table |
Low risk of bias: The study appears to be free of other sources of bias. |
| High risk of bias: Had a potential source of bias related to the specific study design used; stopped early due to some data‐dependent process (including a formal‐stopping rule); had extreme baseline imbalance; has been claimed to have been fraudulent; had some other problem. | |
| Unclear: Insufficient information to assess whether an important risk of bias exists; insufficient rationale or evidence that an identified problem will introduce bias. |
Contributions of authors
Draft the protocol: AVF
Study selection: AVF, MGTB
Extract data from studies: AVF, MGTB
Enter data into RevMan: AVF
Carry out the analysis: AVF, MGTB
Interpret the analysis: AVF, MGTB
Draft the final review: AVF, MGTB, VTV
Disagreement resolution: VTV
Update the review: AVF, MGTB, VTV, JCC, JA
Declarations of interest
AVF: none known
MGTB: none known
VTV: none known
JCC: none known
JA: one known
New
References
Additional references
- Aftab SA, Tay KH, Irani FG, Gong Lo RH, Gogna A, Haaland B, et al. Randomized clinical trial of cutting balloon angioplasty versus high‐pressure balloon angioplasty in hemodialysis arteriovenous fistula stenoses resistant to conventional balloon angioplasty. Journal of Vascular & Interventional Radiology 2014;25(2):190‐8. [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
- The global issue of kidney disease. Lancet 2013;382(9887):101. [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
- Barth KH, Gosnell MR, Palestrant AM, Martin LG, Siegel JB, Matalon TA, et al. Hydrodynamic thrombectomy system versus pulse‐spray thrombolysis for thrombosed hemodialysis grafts: a multicenter prospective randomized comparison. Radiology 2000;217(3):678‐84. [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
- Bylsma LC, Gage SM, Reichert H, Dahl SL, Lawson JH. Arteriovenous fistulae for haemodialysis: a systematic review and meta‐analysis of efficacy and safety outcomes. European Journal of Vascular & Endovascular Surgery 2017;54(4):513‐22. [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
- Cho S. The feasibility of surgical salvage of thrombosed arteriovenous fistula by an interventional nephrologist. Kidney Research & Clinical Practice 2017;36(2):175‐81. [MEDLINE: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
- Francisco AL, Cruz JJ, Cases A, Figuera M, Egocheaga MI, Gorriz JI, et al. Prevalence of kidney insufficiency in primary care population in Spain: EROCAP study [Prevalencia de insuficiencia renal en Centros de Atencion Primaria en Espana: Estudio EROCAP]. Nefrologia 2007;27(3):300‐12. [MEDLINE: ] [PubMed] [Google Scholar]
- Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck‐Ytter Y, Alonso‐Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336(7650):924‐6. [MEDLINE: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
- Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction‐GRADE evidence profiles and summary of findings tables. Journal of Clinical Epidemiology 2011;64:383‐94. [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
- Green LD, Lee DS, Kucey DS. A metaanalysis comparing surgical thrombectomy, mechanical thrombectomy, and pharmacomechanical thrombolysis for thrombosed dialysis grafts. Journal of Vascular Surgery 2002;36(5):939‐45. [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
- Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327(7414):557‐60. [MEDLINE: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
- Higgins JP, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
- Hongsakul K, Rookkapan S, Sungsiri J, Boonsrirat U, Kritpracha B. Pharmacomechanical thrombolysis versus surgical thrombectomy for the treatment of thrombosed haemodialysis grafts. Annals of the Academy of Medicine, Singapore 2015;44(2):66‐70. [MEDLINE: ] [PubMed] [Google Scholar]
- Katsanos K, Karnabatidis D, Kitrou P, Spiliopoulos S, Christeas N, Siablis D. Paclitaxel‐coated balloon angioplasty vs. plain balloon dilation for the treatment of failing dialysis access: 6‐month interim results from a prospective randomized controlled trial. Journal of Endovascular Therapy 2012;19(2):263‐72. [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
- National kidney Foundation. 2006 Updates Clinical Practice Guidelines and Recommendations. www.kidney.org/sites/default/files/docs/12‐50‐0210_jag_dcp_guidelines‐va_oct06_sectionc_ofc.pdf (accessed 27 February 2019).
- Kuhan G, Antoniou GA, Nikam M, Mitra S, Farquharson F, Brittenden J, et al. A meta‐analysis of randomized trials comparing surgery versus endovascular therapy for thrombosed arteriovenous fistulas and grafts in hemodialysis. Cardiovascular & Interventional Radiology 2013;36(3):699‐705. [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
- Lee T. Fistula First Initiative: historical impact on vascular access practice patterns and influence on future vascular access care. Cardiovascular Engineering & Technology 2017;8(3):244‐54. [MEDLINE: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ponikvar R. Surgical salvage of thrombosed native arteriovenous fistulas for hemodialysis by interventional nephrologists. Therapeutic Apheresis & Dialysis 2009;13(4):340‐4. [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
- Rooijens PP, Tordoir JH, Stijnen T, Burgmans JP, Smet de AA, Yo TI. Radiocephalic wrist arteriovenous fistula for hemodialysis: meta‐analysis indicates a high primary failure rate. European Journal of Vascular & Endovascular Surgery 2004;28(6):583‐9. [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
- Schuman E, Quinn S, Standage B, Gross G. Thrombolysis versus thrombectomy for occluded hemodyalisis grafts. American Journal of Surgery 1994;167(5):473‐6. [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
- Schünemann HJ, Oxman AD, Higgins JP, Vist GE, Glasziou P, Guyatt GH. Chapter 11: Presenting results and 'Summary of findings' tables. In: Higgins JP, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
- Schünemann HJ, Oxman AD, Higgins JP, Deeks JJ, Glasziou P, Guyatt GH. Chapter 12: Interpreting results and drawing conclusions. In: Higgins JP, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
- Sesso RC, Lopes AA, Thomé FS, Lugon JR, dos Santos DR. 2010 report of the Brazilian dialysis census [Relatório do censo brasileiro de diálise de 2010]. Jornal Brasileiro de Nefrologia 2011;33:442‐7. [PubMed] [Google Scholar]
- Sesso RC, Lopes AA, Thome FS, Lugon JR, Watanabe Y, dos Santos DR. Report of the Brazilian Chronic Dialysis Census 2012 [Relatório do Censo Brasileiro de Diálise Crônica 2012]. Jornal Brasileiro de Nefrologia 2014;36(1):48‐53. [DOI] [PubMed] [Google Scholar]
- SONG Initiative. The SONG Handbook Version 1.0. www.songinitiative.org/reports‐and‐publications/2017.
- Tessitore N, Bedogna V, Poli A, Lipari G, Pertile P, Baggio E, et al. Should current criteria for detecting and repairing arteriovenous fistula stenosis be reconsidered? Interim analysis of a randomized controlled trial. Nephrology Dialysis Transplantation 2014;29(1):179‐87. [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
- Tordoir J, Canaud B, Haage P, Konner K, Basci A, Fouque D, et al. EBPG on vascular access. Nephrology Dialysis Transplantation2007; Vol. 22 Suppl 2:ii88‐117. [MEDLINE: ] [DOI] [PubMed]
- Tordoir JH, Bode AS, Peppelenbosch N, Sande FM, Haan MW. Surgical or endovascular repair of thrombosed dialysis vascular access: Is there any evidence?. Journal of Vascular Surgery 2009;50(4):953‐6. [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
- Uflacker R, Rajagopalan PR, Selby JB, Hannegan C, Investigators of the Clinical Trial Sponsored by Microvena Corporation. Thrombosed dialysis access grafts: randomized comparison of the Amplatz thrombectomy device and surgical thromboembolectomy. European Radiology 2004;14(11):2009‐14. [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
- Saran R, Robinson B, Abbott KC, Agodoa LY, Bhave N, Bragg‐Gresham J, et al. US Renal Data System 2017 Annual Data Report: Epidemiology of Kidney Disease in the United States. www.ajkd.org/article/S0272‐6386(18)30042‐8/fulltext (accessed 27 February 2019). [DOI] [PMC free article] [PubMed]