Forearm versus upper arm grafts for vascular access.

Published

Journal Article (Review)

Forearm and upper arm arteriovenous grafts perform similarly in terms of patency and complications. Primary patency at 1 year for forearm arteriovenous grafts versus upper arm grafts ranges from 22%-50% versus 22%-42%, and secondary patency at 1 year ranges from 78%-89% versus 52%-67%), respectively. Secondary patency at 2 years, ranges from 30%-64% versus 35%-60% for forearm and upper arteriovenous graft, respectively. Ample pre-operative planning is essential to improved clinical success and the decision to place a graft at one location versus the other should be based solely on previous access history, physical exam, appropriate venous imaging, and other factors that make up the clinical picture. Operative implant strategies and risk of complications are very similar between the two configurations. Postoperative ischemia due to steal syndrome is a potential complication that requires immediate attention. Utilization of the proximal radial or ulnar artery for inflow for the graft can minimize risk of clinically relevant steal syndrome.

Full Text

Duke Authors

Cited Authors

  • Gage, SM; Lawson, JH

Published Date

  • March 5, 2017

Published In

Volume / Issue

  • 18 / Suppl. 1

Start / End Page

  • 77 - 81

PubMed ID

  • 28297065

Pubmed Central ID

  • 28297065

Electronic International Standard Serial Number (EISSN)

  • 1724-6032

International Standard Serial Number (ISSN)

  • 1129-7298

Digital Object Identifier (DOI)

  • 10.5301/jva.5000688

Language

  • eng