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Current Experience and Midterm Follow-up of Immediate-Access Arteriovenous Grafts
- Source :
- Annals of Vascular Surgery. 53:123-127
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Background No independent reviews, with midterm follow-up, of current experience with immediate-access arteriovenous grafts (IAAVGs) exist. The goal of this project was to assess the real-world performance of 2 different IAAVGs over a 2-year period at a large tertiary referral center. Methods Between January 2014 and April 2016, all consecutive patients who underwent placement of Acuseal (Gore) or Flixine (Maquet) IAAVGs were identified for retrospective analysis from the electronic medical record and Vascular Quality Initiative database. Primary, primary-assisted and secondary patency rates, time to first cannulation, time to tunneled catheter removal, and overall survival were recorded. Results Forty-three patients were identified to have undergone placement of IAAVG, 31 Acuseal (72%), and 12 Flixine (28%). Of the Acuseal cohort, 7 were implanted with outflow through a HeRO catheter system (Merit Medical). Mean follow-up time was 8.4 months. Overall survival was 57.4% at 18 months. Overall primary, primary assisted, and secondary patency at 18 months were 33.36%, 34.31%, and 51.03%, respectively. Eighty three percent of grafts were successfully cannulated, and 78% of preexisting catheters were removed. Mean time to successful graft cannulation and catheter removal were 14.85 and 32.26 days, respectively. Conclusions Real-world experience with novel arteriovenous access grafts is consistent with results from industry-sponsored studies. Early cannulation of immediate-access grafts can be successfully performed in a wide variety of patients. However, prolonged catheter dwell times persist despite increased rates of successful early-graft cannulation. Further study of methods for promoting catheter removal in this patient population is warranted.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
030232 urology & nephrology
030204 cardiovascular system & hematology
Prosthesis Design
Article
Catheterization
Blood Vessel Prosthesis Implantation
Young Adult
03 medical and health sciences
Arteriovenous Shunt, Surgical
0302 clinical medicine
Renal Dialysis
Blood vessel prosthesis
medicine
Humans
Vascular Patency
Tunneled catheter
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Electronic medical record
Retrospective cohort study
General Medicine
Middle Aged
Blood Vessel Prosthesis
Surgery
Catheter
Treatment Outcome
Cohort
Female
Arteriovenous grafts
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 08905096
- Volume :
- 53
- Database :
- OpenAIRE
- Journal :
- Annals of Vascular Surgery
- Accession number :
- edsair.doi.dedup.....6566f290325770cdcb0f443223c258e4