How Czech and Slovak vascular surgeons and nephrologists accept recommendations of the European Society of Vascular Surgery - survey study
Abstract
Arteriovenous access (AVA) is the cornerstone for the long-term haemodialysis treatment in the patient with end-stage kidney disease. Nowadays, European Society of Vascular Surgery (ESVS) has presented clinical guidelines regarding all aspects of AVA.
The aim of the study was to identify acceptance rate of selected ESVS recommendations among Czech and Slovak vascular surgeons and nephrologists. We carried out a prospective analysis of 7 questions from an online survey collected from January to February 2020. 211 (33 %) of 646 participants responded to the survey.
Questions were divided into two groups, general and surgical. General questions were for both nephrologist and vascular surgeons.
Surgical questions were evaluated only for vascular surgeons. In the first group 190 (90 %) respondents accept, that extremity dominance is important for location of AVA, 186 (89 %) agree that clinically suspected venous hypertension/central vein occlusion is an indication for fistulography, 111 (53 %) agree, that indwelling central venous catheter/pacemaker is an indication for AVA creation in the opposite side.
In the second group, 50 (57 %) agree that patients before AVA creation should be examined with a tourniquet prior to surgery, 45 (51 %) agree, that pre-operative ultrasonography mapping is recommended, 66 (75 %) agree, that the inner radial artery and the cephalic vein should be more than 2.0 mm, and only 9 (10 %) respondents agree that regional anaesthesia is preferred over local anaesthesia for AVA creation. In both Czech and Slovak Republic, preoperative planning is not uniform and ESVS recommendations for AVA are accepted at the level of 57 %.