Related Experiment Videos
Vascular access for haemodialysis with autogenous vein graft arteriovenous fistulas
Insights
Autogenous vein grafts (AVG) were used for arteriovenous fistulae in patients unsuitable for standard procedures. While some AVG experienced complications like failure and thrombosis, others were successfully managed, offering a viable option for difficult cases.
Area of Science:
- Vascular Surgery
- Nephrology
- Dialysis Access
Background:
- Patients requiring hemodialysis often have limited vascular access options.
- Autogenous vein grafts (AVG) can be an alternative when standard arteriovenous fistulae are not feasible.
Purpose of the Study:
- To evaluate the efficacy and complications of using autogenous vein grafts (AVG) for creating arteriovenous fistulae in patients with challenging vascular anatomy.
Main Methods:
- Nine patients received AVG for hemodialysis access due to inadequate native vessels.
- Surgical construction and post-operative monitoring of AVG were performed.
Main Results:
- Three out of nine AVG failed during dialysis treatment at 3, 10, and 14 months.
- One AVG thrombosed but was restored by thromboectomy, later developing a false aneurysm and rupture, which was repaired.
- Another AVG had a false aneurysm at the proximal anastomosis, requiring repair within six weeks.
Conclusions:
- Autogenous vein grafts (AVG) can serve as a salvage option for hemodialysis access in selected patients.
- AVG are associated with potential complications including graft failure, thrombosis, and pseudoaneurysms that require timely management.
Abstract:
Nine autogenous vein grafts (AVG) have been used in nine patients to create arteriovenous fistulae for haemodialysis. All the patients lacked vessels for construction of a regular arteriovenous fistula. Three of the AVG failed during dialysis treatment 3, 10 and 14 months respectively following construction. Another AVG thrombosed but function was restored by thromboectomy. The same graft was later complicated by a false aneurysm and rupture but was then reconstructed with a vein patch. One AVG with a false aneurysm in the proximal anastomosis was repaired within six weeks.