Brachio-infraclavicular axillary interposition graft as a successful tertiary vascular access procedure for hemodialysis

ABSTRACT

This study describes experience with brachio-axillary interposition graft for hemodialysis as a successful tertiary vascular access procedure. The purpose of the study is to assess the role of this procedure in the dialysis access algorithm. Between May [1995] and March [2000], fourteen grafts were placed in 14 patients, with exhausted venous arm sites. No significant post-operative complications occurred, the secondary patency rate after 1 and 2 years was 85.7% and 77% respectively, which were much better than conventional arm bridge fistula 50-70% after one year, Really, this procedure opened the closed doors infront of those miserable patients with chronic renal failure and exhausted all venous arm sites and good enough that the proposed two main problems with this procedure which were heart failure and steal phenomena did not occur with a significant importance. No single case of heart failure occurred in this series also, steal phenomena occurred only in one case with mild degree that there was no need for intervention, So, it might prove reasonable to use this graft earlier in an effort to eliminate the painful, costly and inconvenient multiple revisions frequently required with more conventional grafts