{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T06:53:42Z","timestamp":1790924022263,"version":"4.1.0"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"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>The number of patients aged \u2a7e80\u2009years with end-stage kidney disease is increasing, making vascular access selection increasingly challenging. Although arteriovenous fistula (AVF) is generally preferred, its advantages over arteriovenous graft (AVG) in very elderly patients remain uncertain. This study compared AVF and AVG outcomes in octogenarian patients undergoing hemodialysis access creation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 266 patients \u2a7e80\u2009years who underwent arteriovenous access creation (AVF,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009163 and AVG,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009103). The AVF group was further divided into brachiocephalic fistula (BCF,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009119) and radiocephalic fistula (RCF,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200944), while the AVG group included lower-arm grafts (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200975) and upper-arm grafts (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200928). Maturation and patency outcomes were compared, and Cox regression analysis was performed to identify predictors of primary patency.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      AVF showed significantly higher 1-year primary patency than AVG (63.6% vs 43.5%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.012), whereas secondary patency was similar between the two groups (86.6% vs 86.8%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.99). AVF required a longer time to use than AVG (median 51 vs 41\u2009days,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), whereas AVG more frequently required repeated percutaneous transluminal angioplasty (PTA) after access creation. Within the AVF group, BCF showed higher primary patency compared with RCF (69.4% vs 48.8%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.036), while non-use rates and secondary patency were similar. In multivariable analysis, minimum vein diameter was the only independent predictor of primary patency (HR, 0.37; 95% CI, 0.15\u20130.92;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.033), with an estimated cutoff value of 3.03\u2009mm.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In patients aged \u2a7e80\u2009years, AVF provides superior primary patency despite longer maturation, whereas repeated interventions enabled AVG to achieve comparable secondary patency. These findings support individualized vascular access selection according to expected maturation and clinical circumstances, with preoperative vein diameter serving as an important factor when considering AVF creation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11297298261486404","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:32:02Z","timestamp":1790591522000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of vascular access outcomes in octogenarian patients undergoing hemodialysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5944-6136","authenticated-orcid":false,"given":"Hwa-Hee","family":"Koh","sequence":"first","affiliation":[{"name":"Department of Surgery, Ajou University School of Medicine, Suwon, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6623-2774","authenticated-orcid":false,"given":"Minyu","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0250-2229","authenticated-orcid":false,"given":"Seon-Hee","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5576-8557","authenticated-orcid":false,"given":"Soo Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kisu.2021.11.003"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-43476-1"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-009-9691-1"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1155\/ijne\/9538115"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1159\/000509309"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2008.10.043"},{"key":"e_1_3_3_8_2","article-title":"Comparative outcomes of arteriovenous fistulas and grafts in haemodialysis: meta-analysis with subgroup analysis by fistula type and transposition status","volume":"10","author":"Yang C","year":"2025","unstructured":"Yang C, Yang W, Xiao L, et al. Comparative outcomes of arteriovenous fistulas and grafts in haemodialysis: meta-analysis with subgroup analysis by fistula type and transposition status. 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