Percutaneous Interventions on the Hemodialysis Reliable Outflow Vascular Access Device

Gebhard, T.A.; Bryant, Joshua A.; Grezaffi, J.A.; Pabon‐Ramos, Waleska M.; Gage, Shawn M.; Miller, Michael J.; Husum, K.; Suhocki, Paul V.; Sopko, D.R.; Lawson, Jeffrey H.; Smith, Tony P.; Kim, Charles Y.

doi:10.1016/j.jvir.2012.12.027

Cited by 20 publications

(15 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These findings further support the conclusions of a previous report in which HeRO Graft was prospectively studied in a catheter‐dependent patient population . The findings are also very comparable to those reported by other subsequent investigators in retrospective analyses of HeRO Graft outcomes . Our results should encourage further study and evaluation of the HeRO Graft in certain hemodialysis patient subpopulations who are struggling with their conventional vascular access due to safety, efficacy, or patency challenges.…”

Section: Discussionsupporting

confidence: 90%

“…Since the time these data were generated in the process of the approval of HeRO Graft by the FDA, and kept on file, additional data on HeRO Grafts have been reported in the literature. Of particular interest are three reports, all of which are retrospective, that provide outcomes data on additional 250 HeRO Graft implants . The primary and secondary HeRO Graft outcomes that emerged from these reports are comparable to our findings.…”

Section: Discussionsupporting

confidence: 79%

See 1 more Smart Citation

A Comparison Between the HeRO Graft and Conventional Arteriovenous Grafts in Hemodialysis Patients

Nassar

Glickman

McLafferty

et al. 2014

Seminars in Dialysis

Self Cite

View full text Add to dashboard Cite

Venous stenosis and occlusion are a major cause of vascular access dysfunction and failure. The HeRO Graft bypasses occlusion and traverses stenosis with outflow directly into the central venous circulation. A randomized, multicenter study was conducted to evaluate the efficacy and safety of the HeRO Graft relative to conventional AV grafts. The design was to enroll 143 patients in a 2:1 randomization ratio between HeRO and conventional AV control groups. Data on 72 subjects (52 HeRO Graft and 20 AV graft controls) were obtained. The HeRO Graft and control cohorts were comparable in baseline characteristics. Adequacy of dialysis, bacteremia rates, and adverse events were consistent between groups. Twelve month Kaplan-Meier estimates for primary and secondary patency rates were 34.8% and 67.6% in the HeRO Graft cohort, and 30.6% and 58.4% in the control cohort. There was no statistical difference in terms of patency between groups. The rates of intervention were 2.2/year for HeRO Graft and 1.6/year for the control (p = 0.100). Median days to loss of secondary patency was 238 for HeRO Graft versus 102 for the control (p = 0.032). The HeRO Graft appears to provide similar patency, adequacy of dialysis, and bacteremia rates to those of conventional AV grafts.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 79%

A Comparison Between the HeRO Graft and Conventional Arteriovenous Grafts in Hemodialysis Patients

Nassar

Glickman

McLafferty

et al. 2014

Seminars in Dialysis

Self Cite

View full text Add to dashboard Cite

show abstract

“…The details of interventional procedures are not highlighted in all publications but Gebhard et al 17 describe interventions in their series of 25 patients with HeRO dysfunction. The majority of cases were treated with routine management as would be applied to a thrombosed graft.…”

Section: Discussionmentioning

confidence: 99%

A Review on the Hemodialysis Reliable Outflow (HeRO) Graft for Haemodialysis Vascular Access

Shakarchi

Houston

Jones³

et al. 2015

European Journal of Vascular and Endovascular Surgery

View full text Add to dashboard Cite

This literature review shows that the HeRO graft is an acceptable option for complex dialysis patients who are catheter dependent. Owing to device availability, published data are predominantly North American and further longer-term studies in other populations may be necessary. In this challenging patient group, randomized controlled trials are required to allow comparisons with alternative access options.

show abstract

“…The Hemodialysis Reliable Outflow (HeRO) graft (Merit Medical Systems, Inc.) can bypass this central venous stenosis providing patients with an additional upper extremity long-term access option. [1][2][3][4][5][6][7][8][9][10][11][12][13] The HeRO graft was approved by the US Food and Drug Administration (FDA) in 2008 and consists of both a proprietary Arterial Graft Component and a Venous Outflow Component. 1 The Arterial Graft Component consists of a 6-mm-inner-diameter expanded polytetrafluoroethylene (ePTFE) hemodialysis (HD) graft with rings to provide additional support and resist kinking of the graft near the traditional titanium connecter.…”

Section: Introductionmentioning

confidence: 99%

“…Many authors found HeRO graft patency rates comparable to those of standard arteriovenous grafts (AVGs) and superior infection rates, patency rates, and adequacy of dialysis compared to tunneled dialysis catheters (TDCs). [1][2][3][4][5][6][7][8][9][10][11][12][13] However, the proprietary Arterial Graft Component is not an "early-cannulation" graft. 14,15 Despite some evidence suggesting otherwise, most vascular surgeons are hesitant to allow cannulation of ePTFE grafts without allowing several weeks for tissue incorporation to possibly prolong patency and minimize the risk of bleeding, pseudoaneurysm, and infiltration.…”

Section: Introductionmentioning

confidence: 99%

Early cannulation of the Hemodialysis Reliable Outflow graft

et al. 2019

View full text Add to dashboard Cite

Objective: In complex dialysis patients, central venous stenosis may preclude additional upper extremity access options. The Hemodialysis Reliable Outflow graft (Merit Medical Systems, Inc.) can bypass this stenosis providing patients with an additional upper extremity long-term access option. We report our experience with early-cannulation Hemodialysis Reliable Outflow grafts and compare them to traditional Hemodialysis Reliable Outflow grafts. Methods: We retrospectively reviewed all patients undergoing Hemodialysis Reliable Outflow graft placement from 1 January 2013 through 15 August 2017 at our institution and compared those undergoing placement of traditional Hemodialysis Reliable Outflow grafts and simultaneous tunneled dialysis catheter insertion to those undergoing Hemodialysis Reliable Outflow graft placement using an early-cannulation Hemodialysis Reliable Outflow graft without a tunneled dialysis catheter. Results: A total of 88 patients had 98 Hemodialysis Reliable Outflow grafts inserted throughout this time period. Of these, 61 (62%) were early-cannulation Hemodialysis Reliable Outflow grafts, while 37 (38%) were traditional Hemodialysis Reliable Outflow grafts. Primary, primary-assisted, and secondary patency rates at 1 year were higher for the traditional Hemodialysis Reliable Outflow graft cohort (53.1% vs 25.2%, p < 0.01; 70.1% vs 30.5%, p < 0.01; and 80.4% vs 55.4%, p = 0.07, respectively). There was no difference in the rate of postoperative hematoma, seroma, pseudoaneurysm formation, steal syndrome, or overall graft thrombosis between the two cohorts. Early-cannulation Hemodialysis Reliable Outflow grafts required earlier reintervention for thrombosis and earlier reintervention for any cause when compared to traditional Hemodialysis Reliable Outflow grafts (146 ± 184 days vs 417 ± 272 days, p < 0.01, and 123 ± 169 days vs 401 ± 311 days, p < 0.01, respectively). Conclusion: In complex dialysis patients, early-cannulation Hemodialysis Reliable Outflow grafts have significantly lower 1-year primary and primary-assisted patency rates and require earlier reintervention to maintain this patency compared to traditional Hemodialysis Reliable Outflow grafts.

show abstract

Percutaneous Interventions on the Hemodialysis Reliable Outflow Vascular Access Device

Cited by 20 publications

References 23 publications

A Comparison Between the HeRO Graft and Conventional Arteriovenous Grafts in Hemodialysis Patients

A Comparison Between the HeRO Graft and Conventional Arteriovenous Grafts in Hemodialysis Patients

A Review on the Hemodialysis Reliable Outflow (HeRO) Graft for Haemodialysis Vascular Access

Early cannulation of the Hemodialysis Reliable Outflow graft

Contact Info

Product

Resources

About