Antecubital Jump Revisions for Salvaging Hemodialysis Grafts

Abstract

When expanded polytetrafluoroethylene (PTFE) is used for hemodialysis access, the authors' initial preference is a forearm loop arteriovenous (AV) graft below the antecubital fossa. However, AV graft thrombosis remains a significant problem caused mainly by venous outflow hyperplasia and managed often by either surgical or radiologic thrombectomy and angioplasty. At the time of surgical revision, the lack of an adequate superficial or deep forearm outflow vein below the elbow would require an antecubital (across the elbow) jump bypass revision to a more proximal upper arm vein to salvage the original forearm AV graft. With an increasing interest in monitoring the specific outcomes of the different surgical interventions used to salvage thrombosed hemoaccess, the authors reviewed their most recent 24--month experience of 32 antecubital jump revisions using ring reinforced PTFE. The mean primary patency of these antecubital jump revisions was 8.2 months with 18 presently patent. AV grafts revisions using antecubital jump grafts confer additional patency; they are another important method for salvaging thrombosed AV hemodialysis grafts.

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References

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