Early Results of Brachial Arterio-Arterial Prosthetic Loop (AAPL) for Hemodialysis. Issue 6 (June 2016)

• Record Type: Journal Article
• Authors: Khafagy, T.; Regal, S.; ElKassaby, M.; Saad, E.
• Is Part Of: European journal of vascular and endovascular surgery. Volume 51:Issue 6(2016:Jun.)
• Page Start: 867
• Page End: 871
• Publication Date: 2016-06
• Subjects: Vascular access -- Arterio-arterial loop -- Hemodialysis access -- Brachial arterio-arterial loop -- Alternative dialysis access -- Unusual dialysis access; Blood-vessels -- Endoscopic surgery -- Periodicals; Blood-vessels -- Surgery -- Periodicals; Vascular Surgical Procedures -- Periodicals; Vascular Surgical Procedures -- methods -- Periodicals; Vaisseaux sanguins -- Chirurgie -- Périodiques; Vaisseaux sanguins -- Chirurgie endoscopique -- Périodiques; Blood-vessels -- Endoscopic surgery; Blood-vessels -- Surgery; Endoscopy; Electronic journals; Periodicals; Electronic journals; 617.413005
• DOI: 10.1016/j.ejvs.2016.02.010
• Languages: English
• ISSNs: 1078-5884

Abstract

Abstract : Background: Vascular access has always been the Achilles heel of hemodialysis. Advances in health care have brought forward patients requiring treatment who have no veins suitable for creation of arteriovenous fistula (AVF) or insertion of central venous catheters. Use of an artery as permanent vascular access has been reported by many authors. This study reports brachial AAPL as an efficient and safe access for hemodialysis patients with central venous occlusion. Methods: Between January 2011 and December 2014, 35 brachial arterio-arterial prosthetic loops (AAPL) were created. The age of patients ranged between 27 and 72 years, with a mean age of 52.8 years. Results: The primary patency rates were 87.9%, 70.4%, and 38.8% at 12, 24, and 36 months, respectively. The secondary patency was 90.7%, 80.3%, and 67.6% at 12, 24, and 36 months, respectively, after successful thrombectomy in seven cases. Conclusion: Mid-term follow-up results demonstrate patency rates comparable with those of the synthetic AVF. The rate of complications, although slightly higher than that with traditional synthetic AVF, is still acceptable in this population with no option for access.