Objectives: To study the effect of antiplatelet agents on preventing arteriovenous (AV) fistulae thrombosis in
hemodialysis (HD) patients after surgical thrombectomy (ST) for acute AV fistulae occlusion. Whether post-operative antiplatelet
drugs have similar effects on the patency of AV fistula after surgical thrombectomy in patients with end-stage renal
disease who undergo HD has not been investigated.
Design, Materials and Methods: We employed the Taiwan National Health Insurance Research Database (NHIRD) from
1999 to 2010 to assess the recurrent occlusion requiring ST and longevity of AV fistula after ST in 1049 patients on regular
HD, with or without antiplatelet drugs.
Results: From the propensity-score (PS)-matched NHIRD, Multivariate Cox model demonstrated that concomitant
antiplatelet medication in the HD patients who received the first ST significantly reduced the duration of recurrent ST
(adjusted hazard ratio (HR) 1.69; 95% confidence interval (CI) 1.22-2.35, p=0.002) and the longevity of the fistula
(adjusted HR 1.79; 95% CI 1.31-2.46, p<0.001).
Conclusion: Treatment with antiplatelet drugs in HD patients did not prevent recurrent thrombosis requiring further ST,
but significantly jeopardized the longevity of AV fistula after ST.