Arterioarterial prosthetic loop: A new approach for hemodialysis access

Zanow, J.; Krüger, U.; Petzold, Michael; Petzold, Karen; Miller, H.; Scholz, Hans

doi:10.1016/j.jvs.2005.02.043

Cited by 58 publications

(62 citation statements)

References 29 publications

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“…These differences were compatible with the observations of our study. 8 Present study demonstrated that the AALG graft achieved primary and secondary patency rates at one year of 73.3 % and 86.6% respectively and this is compatible with the secondary patency rate that was over 70% recommended by the National Kidney Foundation. 13 Although the secondary patency rate of 66.7% at three years was lower than that reported in previously published studies, it was still acceptable with regard to the poor vascular conditions and the missing alternatives for vascular access.…”

Section: Discussionsupporting

confidence: 88%

“…8 In present study, the desired sufficient extracorporeal blood flow was 300 mL/min, and the painful reperfusion was not observed.…”

Section: Discussionmentioning

confidence: 58%

“…7 Over a period of 38 months, Zanow et al performed this procedure on 16 patients at the femoral site (n= 3) and the subclavian site (n=13) without any post-operative complications. 8 In the present study, we established AALG for hemodialysis in those patients who had problems with conventional vascular access. The indication for AALG application was strictly controlled in our study, we defined two main indications for AALG access; exhausted upper and lower extremities accesses options including central venous occlusion and Cardiac insufficiency intolerable to additional cardiac load of a high-flow AV graft.…”

Section: Discussionmentioning

confidence: 99%

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Axillary artery loop interposition graft (AALG) as unusual access for hemodialysis

Fareed¹,

Zaid²,

Alkhateep³

2017

Int Surg J

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Background: Life expectancy of end stage renal disease patients continues to lengthen and with the limited durability of vascular accesses, repeat fistula construction at different levels of the upper limb is often necessary and leads ultimately to exhaustion of autogenous vascular access sites. Our experience with alternative vascular access procedures namely the arterio-arterial loop graft in the first part of axillary artery was presented in this study. Methods: From June 2013 to Aug 2017, arterio-arterial interposition loop graft procedures (AALG) for vascular access were performed in 15 patients with end-stage renal disease. Inclusion criteria were patients with unsuitable large deep veins or with cardiac insufficiency intolerable to high-flow arterio-venous fistula. Results: The achieved primary and secondary patency was 73.3 % and 86.6% at 1 year and 53.3 % and 66.7 % at 3 years. Severe infection in whole graft occurred in two patients (13.3%) after 11, 27 months. One patient died six months after operation due to unrelated cause. two patients had pseudoaneurysms after 20 and 28 months at sites of repetitive needle puncture and were treated successfully by segmental replacement. Conclusions: In selected cases and with proper indication the AALG can offer efficient alternative for vascular hemodialysis access and can improve the survival rate of such patients.

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Section: Discussionsupporting

confidence: 88%

“…8 In present study, the desired sufficient extracorporeal blood flow was 300 mL/min, and the painful reperfusion was not observed.…”

Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Axillary artery loop interposition graft (AALG) as unusual access for hemodialysis

Fareed¹,

Zaid²,

Alkhateep³

2017

Int Surg J

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“…23,24 Likewise, interarterial loops were not used because of their theoretical risks of ischemia and distal embolization. Zanow 25 and Bunger 20 reported this last complication in 5% and 3.2% of patients with an interarterial axillary-axillary loop for hemodialysis, respectively. To the best of our knowledge, the feasibility of arteriovenous brachial-brachial fistulas was not evaluated in chronic hemodialysis patients who had undergone one or more earlier attempts at surgical vascular access.…”

Section: Discussionmentioning

confidence: 98%

Axillary loop grafts for hemodialysis access: Midterm results from a single-center study

Jean-Baptiste

Hassen-Khodja

Haudebourg

et al. 2008

Journal of Vascular Surgery

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“…Von Zanow et al [21] wurde die Variante eines arterio-arteriellen Schleifeninterponates axillär und femoral mit guten Langzeitresultaten (primäre 1-Jahres-Offenheitsrate von 73% und 54% nach 3 Jahren) und geringen Risiken einer distalen Embolisation beschrieben. [8].…”

Section: "Exotische" Shunts Und Alternativverfahrenunclassified

Shuntchirurgie bei Hämodialysepatienten

Widmer¹,

Uehlinger

Do³

et al. 2008

Gefässchirurgie

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Aufgrund der demografischen Entwicklung und der ansteigenden Prävalenz des Diabetes mellitus nimmt die Zahl dialysepflichtiger Patienten stetig zu. Bei vielen dieser Erkrankten stellt die Anlage einer autologen arterio-venösen Fistel eine echte Herausforderung dar. Erweist sie sich als unmöglich, muss der Gefäßchirurg mit alternativen Zugängen sowie den Vor-und Nachteilen von alloplastischen und heterologen Prothesen vertraut sein (Teil 1). Früh-und Spätkomplikationen wie Aneurysmen, Stenosen, Verschlüsse, Infekte und Steal-Syndrom sind in der Shuntchirurgie häufig und sollten nach heute gültigen Richtlinien behandelt werden (Teil 2). SchlüsselwörterArterio-venöse Fistel · Prothesenshunt · Terminale Niereninsuffizienz · Hämodialyse · Shuntchirurgie Vascular access surgery in haemodialysis patients. Part 1: Initial placement Abstract Due to demographic development and the increasing prevalence of diabetes mellitus the number of haemodialysis patients is steadily increasing. In many of them creation of an autogenous arteriovenous fistula becomes a real challenge. When impossible the vascular surgeon must be familiar with access alternatives and the use of prosthetic and biological grafts (part 1). Early and late complications such as aneurysms, stenoses, occlusions, infections and steal syndrome are frequent in access surgery and should be treated in accordance with existing guidelines (part 2).

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Arterioarterial prosthetic loop: A new approach for hemodialysis access

Abstract: The AAPL is an unusual but useful and easy-to-perform alternative procedure to create vascular access for hemodialysis. It can provide survival for strictly selected patients in whom conventional vascular access is not possible. The axillary chest AAPL is preferred.

Cited by 58 publications

References 29 publications

Axillary artery loop interposition graft (AALG) as unusual access for hemodialysis

Axillary artery loop interposition graft (AALG) as unusual access for hemodialysis

Axillary loop grafts for hemodialysis access: Midterm results from a single-center study

Shuntchirurgie bei Hämodialysepatienten

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