Prosthetic axillary-axillary arm loop arteriovenous graft for hemodialysis

In this study we present our experience with an alternative technique of vascular access for hemodialysis in which a prosthetic graft was placed as subcutaneous arm loop and anastomosed to the axillary artery and vein.

Patients included in this study were those with end stage renal disease (ESRD) requiring hemodialysis access who did not have suitable vein to perform autogenous AVF in both upper limbs and Duplex examination revealed unsuitable brachial artery to perform prosthetic brachial-axillary access.

Forty-one patients with ESRD underwent axillary-axillary arm loop AVG for hemodialysis. The primary patency rate at 1 year was 63.4% and at 2 years was 21.8%. The secondary patency rate at 1 year was 75.6% and at 2 years was 43.5%.

Axillary-axillary arm loop AVG provides an acceptable option of vascular access for hemodialysis which can be used to recruit all possible configurations in the upper limb before shifting to chest wall options.