Assessment of early cannulation arteriovenous graft in hemodialysis patient

Zidan, Mohamed Hamed; Tawfik, Ahmed; Ibrahim Eldesouky, Amr Alaadin; Soliman, Mahmoud

doi:10.21608/zumj.2023.247930.3002

	Assessment of early cannulation arteriovenous graft in hemodialysis patient
Zagazig University Medical Journal
Articles in Press, Accepted Manuscript, Available Online from 19 November 2023
Document Type: Original Article
DOI: 10.21608/zumj.2023.247930.3002
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Authors
Mohamed Hamed Zidan ¹; Ahmed Tawfik ²; Amr Alaadin Ibrahim Eldesouky ¹; Mahmoud Soliman¹
¹Vascular Surgery Department, Faculty of Medicine, Zagazig University, Egypt
²Vascular surgery
Abstract
Background: Patients receiving hemodialysis (HD) who have inappropriate superficial veins often require arteriovenous grafts (AVGs). Standard arteriovenous grafts (sAVGs) still need to be cannulated for the first time approximately two weeks following implantation. To address this limitation, early cannulation arteriovenous grafts (eAVGs) were proposed. Aim: To assess the clinical outcomes of acuseal arteriovenous graft in Egyptian patients with chronic kidney disease. Methods: This prospective cohort study was conducted at Zagazig University Hospitals. Patients who were newly diagnosed with chronic kidney disease and indicated for renal replacement therapy on a regular basis, along with age and gender matched patients with ESRD and having standard arteriovenous shunt were included in the study. Patients were followed up at 1, 2, 4 and 6 weeks then monthly till completion of 6 month after AVG insertion, or AVG dysfunction. Results: The mean time of first cannulation was 3.7 days, and primary patency was found in 66.7% (20) cases at 6 months, primary assisted patency was recorded in 70% (21) cases at 6 months and secondary patency were 73.3% (22) of cases after 6 months. Access problems such as hematoma was 10% (3), graft site infection 6.7% (2) pseudoaneurysm 6.7% (2), and venous hypertension 13.3% (4). No grafts were removed because of graft-site infection Conclusion: Early cannulation arteriovenous graft is a viable and suitable option for patients with compromised vascular anatomy, as well as those requiring immediate vascular access. The findings indicate favorable patency rates and minimal complication rates.
Keywords
early cannulation; arteriovenous graft; hemodialysis


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