Anaesthesia Choice for Creation of Arteriovenous Fistula (ACCess) study protocol : a randomised controlled trial comparing primary unassisted patency at 1 year of primary arteriovenous fistulae created under regional compared to local anaesthesia.
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Authors
Kearns, Rachel J
Clancy, Marc James
Kingsmore, David
Stevenson, Karen
Jackson, Andrew
Mark, Patrick
Aitken, Margaret
Moonesinghe, Ramani
Gaianu, Lucian
Pettigrew, Gavin
Motallebzadeh, Reza
Karydis, Nikolaos
Vesey, Alex
Singh, Rita
Muniraju, Thalakunte
Suttie, Stuart
Wetherall, Kirsty
Hogg, Rosemary
Thomson, Iain
Nangalia, Vishal
Aitken, Emma
Access collaborative group
ACCess collaborative group
Publication Date
2021-12-22Journal Title
BMJ Open
ISSN
2044-6055
Publisher
BMJ
Volume
11
Issue
12
Language
eng
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Macfarlane, A. J., Kearns, R. J., Clancy, M. J., Kingsmore, D., Stevenson, K., Jackson, A., Mark, P., et al. (2021). Anaesthesia Choice for Creation of Arteriovenous Fistula (ACCess) study protocol : a randomised controlled trial comparing primary unassisted patency at 1 year of primary arteriovenous fistulae created under regional compared to local anaesthesia.. BMJ Open, 11 (12) https://doi.org/10.1136/bmjopen-2021-052188
Abstract
INTRODUCTION: Arteriovenous fistulae (AVF) are the 'gold standard' vascular access for haemodialysis. Universal usage is limited, however, by a high early failure rate. Several small, single-centre studies have demonstrated better early patency rates for AVF created under regional anaesthesia (RA) compared with local anaesthesia (LA). The mechanistic hypothesis is that the sympathetic blockade associated with RA causes vasodilatation and increased blood flow through the new AVF. Despite this, considerable variation in practice exists in the UK. A high-quality, adequately powered, multicentre randomised controlled trial (RCT) is required to definitively inform practice. METHODS AND ANALYSIS: The Anaesthesia Choice for Creation of Arteriovenous Fistula (ACCess) study is a multicentre, observer-blinded RCT comparing primary radiocephalic/brachiocephalic AVF created under regional versus LA. The primary outcome is primary unassisted AVF patency at 1 year. Access-specific (eg, stenosis/thrombosis), patient-specific (including health-related quality of life) and safety secondary outcomes will be evaluated. Health economic analysis will also be undertaken. ETHICS AND DISSEMINATION: The ACCess study has been approved by the West of Scotland Research and ethics committee number 3 (20/WS/0178). Results will be published in open-access peer-reviewed journals within 12 months of completion of the trial. We will also present our findings at key national and international renal and anaesthetic meetings, and support dissemination of trial outcomes via renal patient groups. TRIAL REGISTRATION NUMBER: ISRCTN14153938. SPONSOR: NHS Greater Glasgow and Clyde GN19RE456, Protocol V.1.3 (8 May 2021), REC/IRAS ID: 290482.
Keywords
Vascular surgery, End-stage Renal Failure, Transplant Surgery, Adult Anaesthesia
Identifiers
34937718, PMC8704953
External DOI: https://doi.org/10.1136/bmjopen-2021-052188
This record's URL: https://www.repository.cam.ac.uk/handle/1810/333304
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