Kidney Week

Abstract: SA-PO0445

Evaluating Patency Rates and Complications of Arterioarterial Prosthetic Loop in Patients Undergoing Hemodialysis: A Systematic Review and Meta-Analysis

Session Information

• Dialysis: Vascular Access
  November 08, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 803 Dialysis: Vascular Access

Authors

• Alatefi, Dawood, The University of Jordan, Amman, Amman Governorate, Jordan

Dawood Alatefi, MD

• Elshiekh, Mohamed Osama, University of Gezira, Wad Madani, Al Jazirah, Sudan

Mohamed Osama Elshiekh, MBBS

• Alanzi, Ahmed Khaled, King Hamad University Hospital, Muharraq, Muharraq Governorate, Bahrain

Ahmed Khaled Alanzi, MD

• Alshokri, Mabrouka Melad Emhamed, Benghazi Medical Center, Benghazi, Benghazi district, Libya

Mabrouka Melad Emhamed Alshokri, MBChB

• Farrara, Hajer M, CUNY Graduate Center, New York, New York, United States

Hajer M Farrara, DrMed

• Bakeer, Hibah Bileid, Gharyan Central Hospital, Gharyan, Libya

Hibah Bileid Bakeer, DrMed, MBBS, MBChB

• Zubaidi, Mustafa Sabeeh lafta, Wasit University, Kut, WA, Iraq

Mustafa Sabeeh lafta Zubaidi, MBChB

• Meselhi, Amr, Bedford Hospital NHS Foundation Trust, Luton, United Kingdom

Amr Meselhi, MBBS

• Mohamed, Muner, Ochsner Health, New Orleans, Louisiana, United States

Muner Mohamed, MD, FASN

• Elhadi, Muhammed, Korea University, Seongbuk-gu, Seoul, Korea (the Republic of)

Muhammed Elhadi, MBBS

Group or Team Name

• Ochsner Group.

Background

Arterioarterial prosthetic loop (AAPL) access has emerged as an alternative vascular access option for hemodialysis patients. However, data regarding its long-term patency and associated complications remain inconsistent. This systematic review and meta-analysis aimed to evaluate the primary, assisted, and secondary patency rates of AAPL, as well as to estimate the incidence of early and late complications.

Methods

This review was conducted in accordance with PRISMA guidelines. A comprehensive literature search was performed in PubMed, Scopus, VHL, Embase, Web of Science, and Google Scholar. Studies involving human subjects and reporting patency and complication rates for AAPL in hemodialysis patients were included.

Results

A total of 20 studies comprising 494 patients (mean age: 55.2 years) and 501 procedures were analyzed. The six-month primary patency rate was 91% (95% CI: 86%–95%; I² = 59.7%). At 12, 18, 24, and 36 months, primary patency rates were 77% (95% CI: 70%–84%; I² = 77.6%), 71% (95% CI: 62%–80%; I² = 2.5%), 67% (95% CI: 59%–75%; I² = 0.7%), and 56% (95% CI: 44%–68%; I² = 53.7%), respectively. Assisted primary patency at 12 months was 82% (95% CI: 76%–88%; I² = 0%). Secondary patency rates were 97% at 6 months (95% CI: 95%–99%; I² = 0%), 93% at 12 months (95% CI: 90%–95%; I² = 37.4%), and 79% at 36 months (95% CI: 69%–88%; I² = 46.1%).
Early complications included infection (3%), thrombosis (5%), hematoma (5%), and postoperative bleeding (9%), with a notably high rate of postoperative edema/swelling (52%). The most common comorbidities were diabetes mellitus (53%), hypertension (52%), coronary artery disease (36%), and dyslipidemia (30%).

Conclusion

AAPL offers high initial patency rates but shows a progressive decline over time, along with a significant incidence of early and late complications. High-quality prospective studies are needed to further validate these findings.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025s6esnm0h