Thigh arteriovenous grafts. Quantitative comparison with alternative options: A meta-analysis.

Thigh arteriovenous grafts. Quantitative comparison with alternative options: A meta-analysis.
J Vasc Access. 2018 Mar 01;:1129729818762991
Authors: Lazarides MK, Argyriou C, Koutsoumpelis A, Georgakarakos EI, Georgiadis GS
Abstract
Thigh arteriovenous grafts are required in a number of patients with exhausted upper extremity veins and comprise 1%-5% of the total access procedures performed. Alternative autogenous lower extremity options are the rarely used sapheno-tibial arteriovenous fistulae, the saphenous vein transpositions, and the femoral vein transpositions. The latter have proven to be the most durable lower limb access procedures, with low infection rates and their primary patency rates ranged from 74% up to 87% at 2 years. Synthetic thigh grafts are suitable for patients who are not good candidates for any upper limb or any autogenous lower limb access and their secondary patency rates ranged from 54% up to 83% at 2 years. Thigh grafts often get infected and their average weighed infection rate in 920 such grafts included in eight large series was 22.9%. A literature search was performed to evaluate thigh grafts compared with alternative options using meta-analysis. Lower limb accesses were found superior compared to HeRO® device regarding 1-year primary failure rate (odds ratio = 0.28, confidence interval = 0.09-0.88, p = 0.03) and additionally autogenous lower limb accesses were found superior compared t...

Source: The Journal of Vascular Access - March 22, 2018 Category: Surgery Tags: J Vasc Access Source Type: research