Arteriovenous Grafts: Still a Viable Option? A 5-Year Study

Abstract

Background: Hemodialysis patients require a vascular access that is both reliable and long lasting. Several variables, including population changes and comorbidities, have impacted patency rates. This study analyzes multiple parameters and estimates the patency rates and complications of brachioaxillary arteriovenous (AV) prosthetic grafts used for dialysis access in a single center. Materials and Methods: This was a prospective single-center study conducted at the Ramaiah Medical College Hospital in Bengaluru. This study comprised 92 patients with chronic renal failure who had brachioaxillary AV prosthetic graft surgery for dialysis access between 2018 and 2022. We monitored cases for up to 2 years for complications, and the primary and secondary graft patency rates were reported. Results: Seventy-five percent of the participants were male, with a mean age of 60. Diseases including hypertension (72.9% prevalence), diabetes (38.2%), and coronary artery disease (20.7% prevalence) were also very common. The present investigation found that thrombosis was the most frequent problem, followed by stenosis. In this study, the primary graft patency rates after 1 year and 2 years were 60.5% and 48%, respectively, whereas the secondary graft patency rates at 1 year and 2 years were 69% and 58%, respectively. Conclusion: The outcomes of this study regarding graft patency and complication rates compare favorably with other published data. Therefore, the authors consider brachioaxillary AV to be the optimal HD route when no acceptable forearm veins are available for creating AV fistulas.