AV Graft for Hemodialysis

2011 ◽  
pp. 407-408
Author(s):  
Randall F. Coombs
Keyword(s):  
Av Graft

Changes in duplex ultrasound parameters during maturation according to arteriovenous access types in incident hemodialysis patients

2021 ◽  
pp. 112972982110052
Author(s):  
Jae Jin Lee ◽  
Sun Ryoung Choi ◽  
Eun Ju Lee ◽  
Ha Youn Yang ◽  
Seon Ha Baek ◽  
...  
Keyword(s):  
Pulsatility Index ◽  
Significant Positive Correlation ◽  
Duplex Ultrasound ◽  
Hemodialysis Patients ◽  
Hemodynamic Parameters ◽  
Positive Correlation ◽  
Arteriovenous Access ◽  
Artery Flow ◽  
Ultrasound Parameters ◽  
Av Graft

Background: Little is known about the changes in hemodynamic parameters during arteriovenous (AV) access maturation using duplex ultrasound according to radiocephalic fistula (RCF), brachiocephalic fistula (BCF), and AV graft (AVG) in incident hemodialysis (HD) patient. The objective of this study was to evaluate changes and differences in brachial artery flow rate (BAFR) and related parameters affecting maturation by duplex ultrasound in incident HD patients according to access type. Methods: This study was an observational study conducted from March 2019 to October 2020. During the study period, 109 incident patients underwent new AV access creation, of which 100 were included in the study. The duplex ultrasound was performed on the day prior to access creation, further, day 1, 2 weeks, and 4 weeks later after access creation in incident HD patients. Results: Among all the patients, 38 (38%) received BCF, while 26 (26%) underwent RCF. Of the patients with AVG, 18 (50%) had a forearm loop AVG. The overall mean age was 62.2 ± 13.8 years (range, 32–89). The BAFR increased about 6.9 times in the RCF, 17.4 times in the BCF, and 19.5 times in the AVG at day 1. The median BAFR measured on day 1 was 580.4 mL/min for RC, 1029.0 mL/min for BC, and 1133.0 mL/min for AVG. Relative to the values measured in week 4, the BAFR on day 1 was 69.5% in RCF, 90.6% in BCF, and 93.9% in AVG. The acceleration decreased most significantly on day 1( p < 0.05). The acceleration time increased significantly on day 1 ( p < 0.05) and beyond during maturation in the RCF and BCF. The BAFR of the RCF had a significantly negative correlation with the pulsatility index. The BAFR of the BCF showed a significantly positive correlation with the systolic and diastolic blood pressure but negatively correlated with pulse rate. The BAFR of the AVG showed a significant positive correlation with the diameter of the outflow vein. Conclusions: There were differences in the clinical and duplex parameters during maturation according to access type. The most dramatic changes of duplex parameters were on the day after AV access creation regardless of AV access types. Though RCF had a lower BAFR rate compared to BCF and AVG, it already had a sufficient BAFR required for adequate HD treatment the day after creation. The BAFR of BCF was not different from that of AVG.

Comparison of Experimental and Numerical Simulations of Flow Within an Arterio-Venous Graft

2000 ◽  
Author(s):  
Paul F. Fischer ◽  
Seung Lee ◽  
Francis Loth ◽  
Hisham S. Bassiouny ◽  
Nurullah Arslan
Keyword(s):  
Flow Field ◽  
Steady Flow ◽  
Laser Doppler Anemometry ◽  
Transition To Turbulence ◽  
Flow Conditions ◽  
Venous Graft ◽  
Venous Anastomosis ◽  
Av Graft ◽  
Good Agreement

Abstract This was a study to compare computational and experimental results of flow field inside the venous anastomosis of an arteriovenous (AV) graft. Laser Doppler anemometry (LDA) measurements were conducted inside an upscaled end-to-side graft model under steady flow conditions at Reynolds number 1820 which is representative of the in vivo flow conditions inside a human AV graft. The distribution of the velocity and turbulence intensity was measured at several locations in the plane of the bifurcation. This flow field was simulated using computation fluid dynamics (CFD) and shown to be in good agreement. Under steady flow conditions, the flow field demonstrated an unsteady character (transition to turbulence).

The Mid-Thigh Loop Arteriovenous Graft: Patient Selection, Technique, and Results

2006 ◽  
Vol 72 (9) ◽  
pp. 825-828 ◽  
Author(s):  
John D. Scott ◽  
David L. Cull ◽  
Corey A. Kalbaugh ◽  
Christopher G. Carsten ◽  
Dawn Blackhurst ◽  
...  
Keyword(s):  
Patient Selection ◽  
Femoral Artery ◽  
Common Femoral Artery ◽  
Infectious Complications ◽  
Secondary Patency ◽  
Graft Placement ◽  
Femoral Vessels ◽  
Common Operation ◽  
The Common ◽  
Av Graft

As patient longevity on hemodialysis has increased, surgeons are increasingly challenged to provide vascular access to patients who have exhausted options for access in the upper extremity. A common operation performed on these patients has been the loop thigh arteriovenous (AV) graft based off the common femoral vessels. However, there are several disadvantages of placing prosthetic grafts in proximity to the groin. Our group has modified the thigh loop AV graft procedure by moving the anastomoses to the mid-superficial femoral artery and vein. The advantage of this location is that it preserves the proximal femoral vessels for graft revision and avoids the node-bearing tissue and overhanging panniculus of the groin. The purpose of this study was to review our technique, patient selection, and experience with the mid-thigh loop AV graft procedure. Between 2001 and 2003, 46 mid-thigh loop AV grafts were placed in 38 patients. Patient hospital, office, and dialysis clinic records were reviewed. The primary and secondary patency for AV grafts in this study by life-table was 40 per cent and 68 per cent at 1 year and 18 per cent and 43 per cent at 2 years. There were 10 infections (21%) requiring graft removal. Four patients underwent subsequent placement of a proximal loop thigh AV graft after mid-thigh graft failure. Patient survival was 86 per cent at 1 year and 82 per cent at 2 years. There were no patient deaths related to thigh graft placement. Our results with the mid-thigh loop AV graft compare favorably with published results for thigh loop AV grafts. The procedure preserves the proximal vasculature, permitting graft revision or subsequent proximal graft placement, and may be associated with fewer infectious complications. The mid-thigh loop AV graft procedure should be considered before placement of a thigh loop AV graft based off the common femoral artery and vein.

FLOW CHARACTERIZATION INSIDE A COMPLEX AV GRAFT TO VEIN CONNECTION

2008 ◽  
Vol 41 ◽  
pp. S332 ◽  
Author(s):  
Nurullah Arslan ◽  
Ayşe Büşra Şengül
Keyword(s):  
Flow Characterization ◽  
Av Graft

scholarly journals Treatment of hemodialysis AV graft stenosis: Stents resurgent

2005 ◽  
Vol 67 (2) ◽  
pp. 772-773 ◽  
Author(s):  
John J. White ◽  
William D. Paulson ◽  
Steve J. Schwab
Keyword(s):  
Graft Stenosis ◽  
Av Graft

Intra-access Pressure: Do We Really Need to Know? A Critical Review

2021 ◽  
Vol 4 (1) ◽  
pp. 189-192
Author(s):  
Abaid ur Rehman ◽  
Salman Imtiaz
Keyword(s):  
Early Detection ◽  
Diagnostic Accuracy ◽  
Vascular Access ◽  
Venous Catheter ◽  
Quick Method ◽  
Av Fistula ◽  
Simple Tool ◽  
Monitoring And Surveillance ◽  
Access Complications ◽  
Av Graft

  Arteriovenous (AV) fistula and AV graft are considered superior to venous catheter access, remarkable success has been achieved in increasing prevalence of AV fistula. However, vascular access complications are common and result in increased hospitalization, mortality and expense. Guidelines suggest various methods to maintain patency of vascular access. Amongst these various methods used for vascular access monitoring and surveillance, intra-access pressure (PIA) is a simple tool which can be helpful in early detection and management of stenosis in vascular access. Intra-access pressure, although a very simple and quick method of vascular access evaluation, has a low diagnostic accuracy in prediction of vascular access stenosis as compared to other methods of access surveillance. We discuss here the physiology, methodology and the utility of intra-access pressure.

Prosthetic Arteriovenous Grafts for Hemodialysis

2009 ◽  
Vol 10 (3) ◽  
pp. 137-147 ◽  
Author(s):  
Jacob A. Akoh
Keyword(s):  
Graft Infection ◽  
Fold Increase ◽  
Graft Patency ◽  
Secondary Patency ◽  
Av Fistula ◽  
Full Physical Examination ◽  
Anastomotic Angle ◽  
Steal Syndrome ◽  
Av Graft

Introduction Prosthetic arteriovenous (AV) grafts are indicated in patients with failed AV fistula (AVF), exhausted superficial veins or unsuitable vessels. Increasing the proportion of prevalent hemodialysis (HD) patients using autogenous AVF should reduce the need for AV grafts and associated morbidity. This paper reviews the current role of prosthetic AV grafts in vascular access for HD. Technical considerations Prior to the insertion of a prosthetic AV graft, a comprehensive review of previous access procedures and full physical examination in addition to vessel mapping is required. Anastomotic technique should take into account the flow diffuser concept, graft geometry and an anastomotic angle of 15° in order to reduce the incidence of intimal hyperplasia. Results Many authors report 1 and 2-yr cumulative graft patency rates of 59–90% and 50–82%, respectively. The major drawbacks with synthetic grafts include: thrombosis, a five-fold increase in infection risk and steal syndrome. The choice between surgical and percutaneous methods of dealing with blocked AV grafts remains controversial, though percutaneous techniques are assuming an increasingly important role. Percutaneous strategies are successful in declotting access in 67–95% of cases. Stenting of stenotic lesions following thrombectomy improves secondary patency rates. Strategies for dealing with AV graft infection include antibiotic prophylaxis, partial, subtotal or total graft excision and the use of biological prosthesis. Conclusions Though more prone to complications than autogenous AVFs, AV grafts offer a short maturation period and are more amenable to thrombectomy by radiological or surgical means. Complex AV grafts may be appropriate in patients with exhausted access sites.

Study of prolong arteriovenous (AV) graft

2006 ◽  
Vol 39 ◽  
pp. S609
Author(s):  
G.T. Carroll ◽  
M. Egan ◽  
F. Wallis ◽  
M.T. Walsh ◽  
T.M. McGloughlin
Keyword(s):  
Av Graft
Sign in / Sign up

Export Citation Format

Share Document