Abstract

Anticoagulation and antiplatelet therapy effectively inhibit neointimal hyperplasia (NIH) in both arterial and venous systems but not in arteriovenous fistulae (AVF). The main site of AVF failure is the juxta-anastomotic area that is characterized by disturbed flow compared to laminar flow in the arterial inflow and the venous outflow. We hypothesize that early thrombus formation is required for eccentric and heterogenous NIH under disturbed flow.