Experience of HeRO Dialysis Graft Placement in a Challenging Population. (May 2013)

• Record Type: Journal Article
• Authors: Kokkosis, Angela A.; Abramowitz, Steven D.; Schwitzer, Jonathan; Schanzer, Harry; Teodorescu, Victoria J.
• Is Part Of: Vascular & endovascular surgery. Volume 47:Number 4(2013)
• Page Start: 278
• Page End: 280
• Publication Date: 2013-05
• Subjects: hemodialysis -- arteriovenous graft -- HeRO -- central venous occlusion -- central venous obstruction; Blood-vessels -- Surgery -- Periodicals; Blood-vessels -- Endoscopic surgery -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioplasty -- Periodicals; Surgical Procedures, Minimally Invasive -- Periodicals; Vascular Diseases -- surgery -- Periodicals; Vaisseaux sanguins -- Chirurgie -- Périodiques; Vaisseaux sanguins -- Chirurgie endoscopique -- Périodiques; 617.41
• DOI: 10.1177/1538574413481117
• Languages: English
• ISSNs: 1538-5744

Abstract

Objective: To assess the outcomes of the hemodialysis reliable outflow (HeRO) device in a subset of hemodialysis access-challenged patients with central venous obstruction. Methods: Retrospective analysis of a series of patients in 2 centers who underwent placement of the HeRO device between September 2009 and November 2010. Patients' demographics, access history, HeRO patency, and number of reinterventions were analyzed. Results: Eleven patients underwent 12 HeRO implantations. The average duration of dialysis prior to HeRO placement was 5.55 ± 3.64 years. Primary and secondary patencies at 6 months and 1 year were 36.4% and 54.5% and 9.1% and 45.5%, respectively. Conclusions: In the end-stage renal disease population with central venous occlusive disease, the HeRO device offers the best long-term dialysis option when an arteriovenous fistula or graft is not possible. Close follow-up and subsequent aggressive interventions can prolong the use of the HeRO and avoid the last resort of dialysis catheters.