DR S DEVI PRIYA,DR SANTHOSH VR,DR RENUKA PALADUGULA,DR.K. PADMAVATHY
DOI: https://doi.org/Background:Arteriovenous fistula (AVF) is the preferred vascular access for haemodialysis in patients with chronic renal failure. However, early AVF failure due to thrombosis and inadequate maturation remains a significant challenge in haemodialysis. This study aimed to compare the efficacy of antiplatelet and anticoagulant therapies in improving AVF patency.
Methods:In this prospective comparative study, 156 patients were randomly allocated to three groups: Group 1 received aspirin (75 mg), Group 2 received aspirin (75 mg) plus acitrom (1 mg), and Group 3 received clopidogrel (75 mg). Medications were initiated on postoperative day 1. Clinical and ultrasonographic assessments were performed at 2, 4, 6, and 12 weeks. The primary outcome was AVF patency at 12 weeks postoperatively. Secondary outcomes included thrombosis, early cannulation feasibility and complications.
Results:At 12 weeks, patency was highest in Group 2 (84.6%), followed by Group 1 (73.1%) and Group 3 (67.3%). Thrombosis was least frequent in Group 2 (9.6%), while Group 1 reported 21.2%, and Group 3 had the highest incidence at 26.9%. Early cannulation feasibility was highest in Group 2 (78.8%). Minor and major bleeding events were more common in Group 2 (13.5% and 3.8%, respectively). Surgical site infections and haematoma formation were most frequent in group 3.
Conclusion:The combination of aspirin and acitrom led to the best outcomes in maintaining AVF patency and reducing thrombosis risk at 12 weeks. However, this regimen carries a higher risk of bleeding complications. Patient-specific risk factors must be considered when choosing a postoperative regimen to balance efficacy and safety of the treatment.
