Saphenous vein autograft for long term hemodialysis

ABSTRACT

The analogous saphenous vein was used as a blood access graft in t he upper arm, between the brachial artery and the axillary vein for lognterm hemodialysis in 18 patients, representing 155 of all patients referred to our outpatient clinic for A-V fistula, in the period from 1/96 to 3/97. This modality was used because 50% of those patients were obese, with deep superficial veins, 27.8% have small inadequate vessels and in 22.2% the superficial veins were thrombosed and exhausted. Patency rate was 83.3% for a follow up period ranging from 15-27 months with a Thrombosis occurred in 16.7%, infection in 5.6%, haematoma in 11.1%, aneurismal dilatation in 11.1% and arterial steal in 5.6% of the patients. Reassessment of 10 patients out of the 18 was done for another 12 months, during this period aneuismal dilation appeared in another 5 patients, arterial steal in one patient, and haematoma at the site of puncture in one patient. Saphenous vein autograft can be considered a good alternative modality for blood access when the primary form can't be used