Author/Editor		Ponikvar, R; Buturović-Ponikvar, J
Title		The impact of antiaggregating drugs on native arteriovenous fistula survival: clopidogrel vs. aspirin
Type		članek
Source		In: Buturović-Ponikvar J, Bren AF, editors. Zbornik 2. slovenski nefrološki kongres z mednarodno udeležbo ob 30. letnici dialize in transplantacije ledvic v Sloveniji; 2000 sep 27-30; Brdo pri Kranju. Ljubljana: Klinični center, Klinični oddelek za nefrologijo,
Publication year		2000
Volume		str. 175-8
Language		eng
Abstract		In the prospective, randomised clinical study, the impact of antiaggregating activity of clopidogrel vs. aspirin on native arteriovenous fistula (AVF) survival was assessed. Immediately after surgery patients were randomly assigned into three groups: a) clopidogrel 75 mg daily for 1 year; b) clopidogrel 75 mg daily for 4 weeks; c) aspirin 100 mg daily for 1 year. Radial artery and veins were examined by duplex Doppler before the surgery to determine the optimal site for anastomosis. End-to-side anastomosis of cephalic vein to radial artery, approximately 10 mm long, was performed by the same surgeon. Maturation time was 28 days. End point was thrombosis of AV fistula. After the surgery maturation and function of AV fistula was assessed clinically and with duplex-Doppler. During the therapy with clopidogrel and aspirin tolerability and side effects were carefully monitored. Platelet and white cells count and LDH were checked every week in the first month, beweekly in the second month and once a month thereafter. Totally 12 patients were up to now enrolled into the study, 5 men, 7 women, aged from 24 82 years (mean 54+-16). There were 4 patients in group A, 6 patients in group B and 2 patients in group C. All AVF were still patent. White blood cell and platelet count were normal. All AV fistulas have been normally functioning during study period. 11/12 AVF have already been used. No thrombocytopenia or leukocytopenia as well as signs or symptoms of HUS/TTP were observed during the study. The only serious complication was gastrointestinal bleeding five days after institution of aspirin in one patient. Untill now application of clopidogrel in chronic dialysis patients was safe.
Descriptors		ARTERIOVENOUS SHUNT, SURGICAL PLATELET AGGREGATION INHIBITORS ASPIRIN HEMODIALYSIS RADIAL ARTERY ULTRASONOGRAPHY, DOPPLER, DUPLEX