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

Alan J. R. Macfarlane; Rachel J. Kearns; Marc James Clancy; David Kingsmore; Karen Stevenson; Andrew P. Jackson; Patrick Mark; Margaret Aitken; Suneetha Ramani Moonesinghe; Cecilia Vindrola-Padros; Lucian Gaianu; Gavin Pettigrew; Reza Motallebzadeh; Nikolaos Karydis; Alex Vesey; Rita Singh; Thalakunte Muniraju; Stuart Suttie; Alex McConnachie; Kirsty Wetherall; Kariem El-Boghdadly; Rosemary Hogg; Iain Thomson; Vishal Nangalia; Emma Aitken

doi:10.1136/bmjopen-2021-052188

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

Alan J. R. Macfarlane, Rachel J. Kearns, Marc James Clancy, David Kingsmore, Karen Stevenson, Andrew P. Jackson, Patrick Mark, Margaret Aitken, Suneetha Ramani Moonesinghe, Cecilia Vindrola-Padros, Lucian Gaianu, Gavin Pettigrew, Reza Motallebzadeh, Nikolaos Karydis, Alex Vesey, Rita Singh, Thalakunte Muniraju, Stuart Suttie, Alex McConnachie, Kirsty WetherallKariem El-Boghdadly, Rosemary Hogg, Iain Thomson, Vishal Nangalia, Emma Aitken

Centre for Human & Applied Physiological Sciences

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

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.

Original language	English
Article number	e052188
Journal	BMJ Open
Volume	11
Issue number	12
DOIs	https://doi.org/10.1136/bmjopen-2021-052188
Publication status	Published - Dec 2021

Access to Document

10.1136/bmjopen-2021-052188

Fingerprint

Dive into the research topics of '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'. Together they form a unique fingerprint.

Cite this

Macfarlane, A. J. R., Kearns, R. J., Clancy, M. J., Kingsmore, D., Stevenson, K., Jackson, A. P., Mark, P., Aitken, M., Moonesinghe, S. R., Vindrola-Padros, C., Gaianu, L., Pettigrew, G., Motallebzadeh, R., Karydis, N., Vesey, A., Singh, R., Muniraju, T., Suttie, S., McConnachie, A., ... Aitken, E. (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), Article e052188. https://doi.org/10.1136/bmjopen-2021-052188

@article{bfb2df5c19fd46e893fd357436e6b6e2,

title = "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",

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.",

author = "Macfarlane, {Alan J. R.} and Kearns, {Rachel J.} and Clancy, {Marc James} and David Kingsmore and Karen Stevenson and Jackson, {Andrew P.} and Patrick Mark and Margaret Aitken and Moonesinghe, {Suneetha Ramani} and Cecilia Vindrola-Padros and Lucian Gaianu and Gavin Pettigrew and Reza Motallebzadeh and Nikolaos Karydis and Alex Vesey and Rita Singh and Thalakunte Muniraju and Stuart Suttie and Alex McConnachie and Kirsty Wetherall and Kariem El-Boghdadly and Rosemary Hogg and Iain Thomson and Vishal Nangalia and Emma Aitken",

note = "Funding Information: Funding This work is supported by National Institute for Health Research (NIHR) (Health Technology Assessment 130 567). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. Publisher Copyright: {\textcopyright}",

year = "2021",

month = dec,

doi = "10.1136/bmjopen-2021-052188",

language = "English",

volume = "11",

journal = "BMJ Open",

issn = "2044-6055",

publisher = "BMJ Publishing Group",

number = "12",

}

Macfarlane, AJR, Kearns, RJ, Clancy, MJ, Kingsmore, D, Stevenson, K, Jackson, AP, Mark, P, Aitken, M, Moonesinghe, SR, Vindrola-Padros, C, Gaianu, L, Pettigrew, G, Motallebzadeh, R, Karydis, N, Vesey, A, Singh, R, Muniraju, T, Suttie, S, McConnachie, A, Wetherall, K, El-Boghdadly, K, Hogg, R, Thomson, I, Nangalia, V & Aitken, E 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, vol. 11, no. 12, e052188. https://doi.org/10.1136/bmjopen-2021-052188

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. / Macfarlane, Alan J. R.; Kearns, Rachel J.; Clancy, Marc James et al.
In: BMJ Open, Vol. 11, No. 12, e052188, 12.2021.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - 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

AU - Macfarlane, Alan J. R.

AU - Kearns, Rachel J.

AU - Clancy, Marc James

AU - Kingsmore, David

AU - Stevenson, Karen

AU - Jackson, Andrew P.

AU - Mark, Patrick

AU - Aitken, Margaret

AU - Moonesinghe, Suneetha Ramani

AU - Vindrola-Padros, Cecilia

AU - Gaianu, Lucian

AU - Pettigrew, Gavin

AU - Motallebzadeh, Reza

AU - Karydis, Nikolaos

AU - Vesey, Alex

AU - Singh, Rita

AU - Muniraju, Thalakunte

AU - Suttie, Stuart

AU - McConnachie, Alex

AU - Wetherall, Kirsty

AU - El-Boghdadly, Kariem

AU - Hogg, Rosemary

AU - Thomson, Iain

AU - Nangalia, Vishal

AU - Aitken, Emma

N1 - Funding Information: Funding This work is supported by National Institute for Health Research (NIHR) (Health Technology Assessment 130 567). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. Publisher Copyright: ©

PY - 2021/12

Y1 - 2021/12

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85122396559&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2021-052188

DO - 10.1136/bmjopen-2021-052188

M3 - Article

SN - 2044-6055

VL - 11

JO - BMJ Open

JF - BMJ Open

IS - 12

M1 - e052188

ER -

Macfarlane AJR, Kearns RJ, Clancy MJ, Kingsmore D, Stevenson K, Jackson AP et al. 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. 2021 Dec;11(12):e052188. doi: 10.1136/bmjopen-2021-052188

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

Abstract

Access to Document

Other files and links

Fingerprint

Cite this