OUTCOMES OF ARTERIOARTERIAL PROSTHETIC LOOP GRAFT AS AN ALTERNATIVE HEMODIALYSIS ACCESS.

Abstract

Objective: to describe the technique and study the safety and efficacy of arterioarterial prosthetic loop graft as a hemiodialysis access option in multi-access failure patients. Methods:This is a retrospective single center study which was conducted at the vascular surgery department in KHMC. Data of patients who underwent arterioarterial loop graft in the period between January 2014 and January 2019 was collected and analyzed. Results: 23 patients underwent the procedure. 18 patients underwent anterior chest wall axilloaxillary arterial loop graft while 5 patients underwent arterioarterial loop graft based of the superficial femoral artery (SFA). The primary patency rates at 6, 12, and 18 months were 91.3%, 74%, and 61% respectively. The secondary patency rates at 6, 12, and 18 months were 95.6%, 82.6%, and 78.3% respectively. Three patients developed localized graft infection at the site of puncture. Two patients developed false aneurysms in the body of the graft. 0ne patient developed limb threatening ischemia secondary to graft thrombosis. There was no procedure related mortality. Conclusions: Prosthetic arterioarterial loop graft is a safe and effective hemodialysis access option in carefully selected subsets of end stage renal disease patients.