{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T07:06:57Z","timestamp":1784531217247,"version":"3.55.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2026,7]]},"abstract":"\n Background:<\/jats:title>\n The maturation and patency of arteriovenous fistula (AVF) are crucial in patients requiring hemodialysis (HD). Although several trials have been conducted to evaluate the impact of various medications on AVF maturation, little has been observed. Apixaban, a direct oral anticoagulant, has been shown to have a protective effect against intimal hyperplasia (IH). We therefore aimed to determine the effect of Apixaban on the patency, maturation, and anastomotic size of AVF after creation.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This two-center randomized study included all patients who underwent AVF creation between July 2023 and November 2024. The primary outcome was AVF maturation. Secondary outcomes were complications and mortality. Patients were divided randomly into two groups. The first group (treatment group,\n N<\/jats:italic>\n = 44) received Apixaban 2.5 mg twice daily, while the second group (control group,\n N<\/jats:italic>\n = 48) received no treatment. A Doppler ultrasound was performed for measurement of anastomotic size, vein diameter, and flow volume based on subsequent fistula adequacy. Autogenous AVFs were constructed with end to side anchor technique anastomosis as distally as possible in all patients. Both groups were followed\u2011up for 6 months.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Ninety two patients underwent AVF creation during the study period. After 6 months follow up, the primary patency in the Apixaban group was 90.9%, while it was 79.2% in the control group (\n p<\/jats:italic>\n = 0.117). The incidence of anastomotic stenosis was significantly lower in the Apixaban group compared to the control group (9.1% vs 29.2%,\n p<\/jats:italic>\n = 0.015). A thrombosis event was reported in three cases (6.8%) and nine cases (18.8%), in Apixaban and control groups respectively (\n p<\/jats:italic>\n = 0.09). Patients who received Apixaban encountered a total of ten bleeding episodes (one major and nine minor incidents), accounting for 22.7% of the group (\n p<\/jats:italic>\n = 0.11). It is important to highlight that none of these incidents led to fatalities.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Apixaban might be beneficial for decreasing early AVF maturation failure in patients requiring HD.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/11297298251407275","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T10:06:57Z","timestamp":1770372417000},"page":"1678-1685","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Apixaban on early anastomotic stenosis after arteriovenous fistula creation for hemodialysis"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5242-3214","authenticated-orcid":false,"given":"Mahmoud I","family":"Attia","sequence":"first","affiliation":[{"name":"Vascular Surgery Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Islam M","family":"Atta","sequence":"additional","affiliation":[{"name":"Vascular Surgery Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherif M","family":"Essam","sequence":"additional","affiliation":[{"name":"Vascular Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr N","family":"Kamel","sequence":"additional","affiliation":[{"name":"Vascular Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nader M","family":"Hamada","sequence":"additional","affiliation":[{"name":"Vascular Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2016.02.001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2018.02.001"},{"issue":"4","key":"e_1_3_2_4_2","first-page":"451","article-title":"The effect of antiplatelet drugs on the patency rate of arterio-venous fistulae in hemodialysis patients","volume":"9","author":"Rouzrokh M","year":"2010","unstructured":"Rouzrokh M, Abbasi MR, Mirshemirani AR, et al. The effect of antiplatelet drugs on the patency rate of arterio-venous fistulae in hemodialysis patients. Iran J Pharm Res 2010; 9(4): 451.","journal-title":"Iran J Pharm Res"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2016.299"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1159\/000343669"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacbts.2021.06.006"},{"key":"e_1_3_2_8_2","article-title":"Medical adjuvant treatment to increase patency of arteriovenous fistulae and grafts","volume":"7","author":"Da Silva A","year":"2021","unstructured":"Da Silva A. Medical adjuvant treatment to increase patency of arteriovenous fistulae and grafts. Cochrane Database Syst Rev 2021; 7: CD002786.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2013.290"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.628"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.9739\/tjvs.2022.09.03"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.12.001"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.07.090"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15048"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2022.04.030"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/10760296211063882"},{"issue":"1","key":"e_1_3_2_17_2","first-page":"12029","article-title":"Efficacy and safety of Apixaban for the prevention of thrombosis in arteriovenous grafts","volume":"34","author":"Hedayat A","year":"2024","unstructured":"Hedayat A, Soltani AE, Hakiminezhad M, et al. Efficacy and safety of Apixaban for the prevention of thrombosis in arteriovenous grafts. Eur J Transl Myol 2024; 34(1): 12029.","journal-title":"Eur J Transl Myol"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nefroe.2022.01.006"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-023-01814-6"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.23876\/j.krcp.2018.37.3.277"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.4103\/0971-4065.139490"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.18.2164"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2016090980"},{"issue":"10","key":"e_1_3_2_24_2","article-title":"Safety and efficacy of apixaban vs warfarin in patients with stage 4 and 5 chronic kidney disease: a systematic review","volume":"14","author":"Fatima H","year":"2022","unstructured":"Fatima H, Nwankwo I, Anam M, et al. Safety and efficacy of apixaban vs warfarin in patients with stage 4 and 5 chronic kidney disease: a systematic review. 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