Axillary-axillary interarterial chest loop conduit as an alternative for chronic hemodialysis access

Bünger, Carsten Michael; Kröger, Jens; Kock, Lars; Henning, Andreas; Klar, E.; Schareck, W.

doi:10.1016/j.jvs.2005.04.022

Cited by 36 publications

(36 citation statements)

References 26 publications

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“…23,24 Likewise, interarterial loops were not used because of their theoretical risks of ischemia and distal embolization. Zanow 25 and Bunger 20 reported this last complication in 5% and 3.2% of patients with an interarterial axillary-axillary loop for hemodialysis, respectively. To the best of our knowledge, the feasibility of arteriovenous brachial-brachial fistulas was not evaluated in chronic hemodialysis patients who had undergone one or more earlier attempts at surgical vascular access.…”

Section: Discussionmentioning

confidence: 98%

Axillary loop grafts for hemodialysis access: Midterm results from a single-center study

Jean-Baptiste

Hassen-Khodja

Haudebourg

et al. 2008

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 98%

Axillary loop grafts for hemodialysis access: Midterm results from a single-center study

Jean-Baptiste

Hassen-Khodja

Haudebourg

et al. 2008

Journal of Vascular Surgery

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“…9,10 The arterio-arterial grafts on thigh were also described well previously, but thrombosis rate of the femoro-inguinal arterioarterial prosthetic loop was high. 11,12 In the present study, the demographic character of the patients showed the mean patient age was 58±13 years; 60% were women. Comorbid conditions included diabetes mellitus (66.7%), coronary heart diseases (60%), hyperlipidemia (53.3%).…”

Section: Discussionmentioning

confidence: 45%

Axillary artery loop interposition graft (AALG) as unusual access for hemodialysis

Fareed¹,

Zaid²,

Alkhateep³

2017

Int Surg J

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Background: Life expectancy of end stage renal disease patients continues to lengthen and with the limited durability of vascular accesses, repeat fistula construction at different levels of the upper limb is often necessary and leads ultimately to exhaustion of autogenous vascular access sites. Our experience with alternative vascular access procedures namely the arterio-arterial loop graft in the first part of axillary artery was presented in this study. Methods: From June 2013 to Aug 2017, arterio-arterial interposition loop graft procedures (AALG) for vascular access were performed in 15 patients with end-stage renal disease. Inclusion criteria were patients with unsuitable large deep veins or with cardiac insufficiency intolerable to high-flow arterio-venous fistula. Results: The achieved primary and secondary patency was 73.3 % and 86.6% at 1 year and 53.3 % and 66.7 % at 3 years. Severe infection in whole graft occurred in two patients (13.3%) after 11, 27 months. One patient died six months after operation due to unrelated cause. two patients had pseudoaneurysms after 20 and 28 months at sites of repetitive needle puncture and were treated successfully by segmental replacement. Conclusions: In selected cases and with proper indication the AALG can offer efficient alternative for vascular hemodialysis access and can improve the survival rate of such patients.

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“…There are other upper limb options such as the interarterial axillary-axillary graft of which there is a case series with primary and secondary patency of 90% and 93% at six months. However, these patients had completely exhausted venous options, and thus the risks of an artery-to-artery graft were worthwhile [17]. A variety of lower limb procedures have been described and use of the saphenous vein as a conduit has rather lost favour due to the high rates of failure and need for further intervention [18–22].…”

Section: Discussionmentioning

confidence: 99%

Midterm Experience of Ipsilateral Axillary-Axillary Arteriovenous Loop Graft as Tertiary Access for Haemodialysis

Hunter

Nicholson

2014

Journal of Transplantation

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Objectives. To present a series of ipsilateral axillary artery to axillary vein loop arm grafts as an alternative vascular access procedure for haemodialysis in patients with difficult access. Design. Retrospective case series. Methods. Patients who underwent an axillary loop arteriovenous graft from September 2009 to September 2012 were included. Preoperative venous imaging to exclude central venous stenosis and to image arm/axillary veins was performed. A cuffed PTFE graft was anastomosed to the distal axillary artery and axillary vein and looped on the arm. Results. 25 procedures were performed on 22 patients. Median age was 51 years, with 9 males and 13 females. Median number of previous access procedures was 3 (range 0–7). Median followup was 16.4 months (range 1–35). At 3 months and 1 year, the primary and secondary patency rates were 70% and 72% and 36% and 37%, respectively. There were 11 radiological interventions in 6 grafts including 5 angioplasties and 6 thrombectomies. There were 19 surgical procedures in 10 grafts, including thrombectomy, revision, repair for bleeding, and excision. Conclusions. Our series demonstrates that the axillary loop arm graft yields acceptable early patency rates in a complex group of patients but to maintain graft patency required high rates of surgical and radiological intervention, in particular graft thrombectomy.

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Axillary-axillary interarterial chest loop conduit as an alternative for chronic hemodialysis access

Cited by 36 publications

References 26 publications

Axillary loop grafts for hemodialysis access: Midterm results from a single-center study

Axillary loop grafts for hemodialysis access: Midterm results from a single-center study

Axillary artery loop interposition graft (AALG) as unusual access for hemodialysis

Midterm Experience of Ipsilateral Axillary-Axillary Arteriovenous Loop Graft as Tertiary Access for Haemodialysis

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