{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:46:31Z","timestamp":1791740791611,"version":"4.3.4"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"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"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Early thrombosis is the most common cause of arteriovenous fistula (AVF) failure within the first month after AVF creation. The necessity of heparin use to prevent early thrombosis in AVF surgery is still debated. This study evaluated the effect of the \u201cTargeted Intraluminal Heparinization and Flushing\u201d technique, which provides direct anticoagulation and intraluminal flushing to the fistula vein without requiring additional venous puncture, on early outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      In our clinic, AVF surgeries performed for hemodialysis purposes between 2015 and 2025 were retrospectively evaluated. The 300 patients in the study were divided into three groups based on the intraoperative heparin administration method. Group 1 (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009100) consisted of patients who did not receive heparin during AVF creation, Group 2 (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009100) consisted of patients who received systemic heparin via a separate venous puncture, and Group 3 (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009100) consisted of patients who received intraluminal heparin directly into the target vein before anastomosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In 300 patients undergoing AVF creation, the early thrombosis rate was 13.3%. Thrombosis rates were 22% in Group 1, 13% in Group 2, and 5% in Group 3, with a statistically significant difference between groups (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Additionally, pairwise comparisons showed that thrombosis rates were significantly lower in Group 3 than in Groups 1 and 2. Minor bleeding and hematoma rates were 7% in Group 1, 11% in Group 2, and 10% in Group 3, with no significant difference between groups (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.62). No major bleeding was observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In AVF surgery, targeted intraluminal heparinization with flushing may improve early AVF patency by reducing thrombosis rates without increasing bleeding complications. Further prospective studies are needed to demonstrate the effectiveness of this approach more clearly.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11297298261485659","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:23:45Z","timestamp":1791458625000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Targeted intraluminal heparinization with flushing in arteriovenous fistula surgery: A practical approach"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2000-3845","authenticated-orcid":false,"given":"G\u00fcler G\u00fclsen","family":"Ersoy","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Kastamonu University, Kastamonu, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-023-03123-3"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm15031144"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298221076582"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semvascsurg.2005.05.002"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.6026\/973206300211149"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.5527\/wjn.v1.i3.69"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.13101122"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/2965743"},{"issue":"5","key":"e_1_3_2_10_2","first-page":"379","article-title":"Effect of heparin on the patency of arteriovenous fistula","volume":"46","author":"Ravari H","year":"2008","unstructured":"Ravari H, Kazemzade GH, Sarookhani A, et al. Effect of heparin on the patency of arteriovenous fistula. Acta Med Iran 2008; 46(5): 379\u2013382.","journal-title":"Acta Med Iran"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000484"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2018.06.031"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313481007601020"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2007.09.002"},{"issue":"4","key":"e_1_3_2_15_2","first-page":"222","article-title":"Role of systemic anticoagulation in patients undergoing vascular access surgery","volume":"10","author":"Bhomi KK","year":"2008","unstructured":"Bhomi KK, Shrestha S, Bhattachan CL. Role of systemic anticoagulation in patients undergoing vascular access surgery. Nepal Med Coll J 2008; 10(4): 222\u2013224.","journal-title":"Nepal Med Coll J"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000598"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwae098"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/112972980700800404"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.4103\/ijves.ijves_64_22"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298261485659","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298261485659","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298261485659","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:08:41Z","timestamp":1791738521000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298261485659"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":18,"alternative-id":["10.1177\/11297298261485659"],"URL":"https:\/\/doi.org\/10.1177\/11297298261485659","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,8]]},"article-number":"11297298261485659"}}