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Abstract: FR-PO732

Outcomes of Expanded Polytetrafluoroethylene Vascular Grafts as Dialysis Access in Chinese Population: A Retrospective Study

Session Information

Category: Dialysis

  • 704 Dialysis: Vascular Access

Authors

  • Luo, Yuan, The second affiliated hospital of nanjing medical university kidney centre in China, Nanjing, China
  • Bian, Xueqin, The second affiliated hospital of nanjing medical university kidney centre in China, Nanjing, China
  • Ye, Hong, The second affiliated hospital of nanjing medical university kidney centre in China, Nanjing, China
  • Yang, Junwei, The second affiliated hospital of nanjing medical university kidney centre in China, Nanjing, China
Background

With the increased prevalence of end stage renal disease and extended life expectancy of hemodialysis patients, more and more patients had limited quality and availability of superficial vessels for fistula. It is recommended to apply expanded polytetrafluoroethylene (ePTFE) vascular grafts if native fistula is not possible. The aim of our study is to analysis the outcomes of arteriovenous graft (AVG) in our dialysis center.

Methods

It was a retrospective study enrolled all the patients who underwent AVG from October 2014 to December 2017 in our dialysis center. The demographic characteristics, dialysis duration, laboratory tests, location and configuration of AVG, operation outcome,as well as the patency rate were analyzed.

Results

A total of 222 patients with the mean age of 60.5±13.9 were included in this study. 56% of the study population was female. The most common comorbidities were hypertension (84%) and diabetes (49%). All the grafts were successfully implanted. The follow-up period ranged from 3 to 40 months. The configurations of the grafts were 73% loop and 27% straight, and 57% of them were implanted in forearms. There was no operation-related mortality. However, 3 early failure were noted. The primary and secondary patency rates were 81% and 98%, 63% and 92%, 49% and 82%, 30% and 63%, at 6, 12, 24, 36 months after the surgery, respectively. The primary and secondary patency of grafts in forearm was markedly better than those in upper arm. Comorbidities and configurations were not correlated with patency. There were 160 postoperative complications developed in 96 patients during the study period, including thrombosis (74), proximal vein stenosis (72), infection (11), bleeding with hematoma (1), steal syndrome (1), and pseudoaneurysm (1).

Conclusion

AVGs implanted in forearm has superior primary and secondary patency than in upper arm. We recommended using ePTFE grafts as an alternative in patients with poor autogenous vascular conditions.

Funding

  • Government Support - Non-U.S.