Impact of aspirin on the outcome of upper limb AVF placement in hemodialysis patients: Discontinuation or not

Abstract

Background: There is limited research on the consumption of aspirin and its effects on bleeding during arteriovenous fistula (AVF) placement surgery and associated complications in end-stage renal disease (ESRD) patients. Regarding the potential risks imposed on cardiac patients by discontinuing aspirin, the aim of the study was to determine whether aspirin should be discontinued prior to AVF placement surgery.

Methods: This prospective study was carried out at two referral medical centers from 2023 to 2024. The patients were included as 30 patients who routinely took 80 mg of aspirin daily and 30 patients who did not take aspirin. The primary outcomes included the amount of blood loss, and the secondary outcomes included AVF success and maturation time. The amount of bleeding was assessed by the ΔHb (Hb₁-Hb₂), ΔHCT (HCT₁-HCT₂), and intraoperative hemorrhage volume.

Results: Aspirin consumption did not significantly affect any of the examined parameters, including operation duration, hemoglobin decrease, hematocrit decrease, intraoperative hemorrhage, AVF success rate, maturity time, need for blood transfusion, postoperative bleeding, hematoma and thrombosis, hospitalization, and re-Operation (p > 0.05).

Conclusion: Aspirin did not have any significant or negative effects across any of the parameters examined. Based on the findings of this study, there is no need to discontinue aspirin in patients prior to upper limb AVF placement surgery, but further studies are recommended.

Keywords: ASA; Arteriovenous fistula; acetyl salicylic acid; hemodialysis; hemorrhage.