Clinical Application Of Lower Extremity Arteriovenous Grafts In Hemodialysis Patients

Objective This study aimed to analyze the long-term patency of lower extremity arteriovenous grafts(AVG)in hemodialysis patients,providing the information of clinical practice among Chinese patients.Method We retrospectively reviewed 24 hemodialysis patients with lower extremity AVGs from January 2015 and October 2017 and collected the baseline data,comorbidity,perioperative complications.The primary outcome of AVGs patency were primary patency rates,assisted primary patency rates and secondary patency rates.Kaplan-Meier curves were used to describe the primary,assisted primary and secondary patency of AVGs.Still,we described the events due to patency failure and the position of stenosis lesions.Results A total of 24 patients were enrolled in our study.The primary patency,assisted primary patency and secondary patency rates at 6th month,12 th month,24 th month were 83%,67%,and 31%;100%,92% and 62%;100%,96%,and 88%,respectively.9 cases of stenosis and 3 cases of thrombosis was the events contributed to primary patency failure.The events contributed to all patency failure contains 2 cases of pseudoaneurysm,8 cases of thrombus,and 21 cases of stenosis.The distribution of stenotic lesions due to stenosis or thrombus at the first intervention were as follows: arterial anastomosis(3.70%),infra-graft(3.70%),venous anastomosis(51.85%),juxta-anastomosis segment(14.80%),outflow venous segment(11.11%),iliac vein(14.80%).Conclusion: The patency of AVG in lower extremity was lower than upper extremity,but lower extremity AVG still could be a viable option for patients without usable vein in upper extremity to create vascular access.