Iwfal ...re PRTO and the following comment posted by poorgradstudent post # 206585
" Based on the method of action, there's no reason why this should work in radiocephalic AVFs and not brachiocephalic AVF.
Their clinical data to date sure looks like opportunistic highlighting of some endpoints sometimes, and not other times, as well as a dose of good, old-fashioned subgroup analyses. "
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I've checked this with my wife ( PA in renal ...write reports on over 100 dialysis patients each week ) who has discussed the above comment with the head of her Renal Dept.
So before reading what follows understand that
1) I'm presenting a "lay mans " recollection of their comments ...I'm not an MD
2) They are recruiting patients for these trials ( Patency 1 and Patency 2 ) ...so they may not be free of bias ( ie they want the trials to succeed ) .
So their comments to the above statement by poster poorgradstudent.
1) They disagree. There are many reasons for why PRTO's Vonapanitise may work better for radiocephalic AVF's vs brachiocephalic AVF's. The primary reasons are condition of patients ( comorbidities eg hypertension ) vessel injury , vessel wall thickness , elastin content in basillic vs lower arm cephalic veins .
2) The radiocephalic AVF at the wrist is the first choice for dialysis access and uses the cephalic vein.
The brachiocephalic AVF in the upper arm often uses the basilic vein for access. As mentioned in PRTO's publications ... treatment to the basillic vein does not generate the same degree of response as treatment to other veins.
3) Since radiocephalic AVF's are usually the first dialysis access created ( other then emergency access ) ...their patients are usually in their best condition at that time . As fistula's fail ( lose patency -blood flow ) , they recreate access up the fore arm. By the time they are forced to use Brachiocephalic AVF's the condition of their patents have usually deteriorated.
So PRTO's Vanopanitise used in Brachiocephalic AVF's is not the same as being used in Radiocephalic AVF's..
They remain optimistic that that 30ug dose used at the R AVF location will show clinical benefit .
Just my "lay mans " notes.
Would appreciate it, if you did a deeper dive into the data .
thx
Kiwi
