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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2015 October;28(5):169-72
Arteriovenous graft used as a vascular access for hemodialysis: 15 years of experience
Novotný R. 1, 2, Brlicová L. 1, 2, Slavíková M. 1, 2, Valesová J. 1, 2, Mitás P. 1, 2, Hlubocký J. 1, 2, Lindner J. 1, 2
1 Second Department of Cardiovascular Surgery, General Teaching Hospital, Prague, Czech Republic;
2 First Faculty of Medicine, Charles University, Prague, Czech Republic
AIM: The aim of this study was to assess our long-term results with the arteriovenous hemodialysis graft (AVG).
METHODS: A total of 1032 AVGs were created in 940 patients between January 1996 and October 2012, accounting for 14% of the total number of all vascular access surgeries performed during this time period at our center. Subsequently a retrospective analysis of our database focusing on the patency, reasons for closure and other complications of AVGs was carried out using the Kaplan-Meier method.
RESULTS: The primary patency after 6 months from the initial surgery was 54%. The primary patency for the time period of 12 months was 29% and 24 months 12%. The primary assisted patency for the time period of 6 months was 93%. The primary assisted patency for the time period of 12 months was 83%, 24 months 69%, 36 months 54.5%, 48 months 44% and 60 months 37%. Secondary patency for the time period of 6 months after the initial surgery was 91%. The secondary patency for 12 months was 87%, 24 months 78%, 36 months 68.6%, 48 months 62%, 60 months 55.8%, 72 months 49%, 84 months 47%, 96 months 40%, 108 months 35% and 120 months (10 years) 31%.
CONCLUSION: Well planned and executed AVG placement with regular ultrasound check-ups of the AVGs lead’s to an early detection of forming pathologies. This allowed us an early endovascular of surgical intervention and thus prolongs the secondary patency. Our results represent an outstanding cooperation between interventional radiologists, nephrologists, ultrasonographists and vascular surgeons.