Abstract:
:Hemodialysis patients with failed upper extremity (arm) access sites comprise 5-10% of the dialysis population. In these patients, arm vessels are either unsuitable for access placement due to trauma or peripheral vascular disease, or have been exhausted following dialysis usage. Synthetic grafts in the lower extremity (thigh) would benefit these patients, but surgeons are often reluctant to place them, due to concerns of infection and vascular complications. As a result, these patients receive tunneled central venous catheters as their permanent dialysis access. Recent studies have shown, however, that survival and complication rates of thigh grafts are similar to arm grafts and fistulas. Moreover, thigh grafts have lower infection and mortality rates than catheters and provide higher blood flows and dialysis adequacy. In this editorial we argue that thigh grafts are the better option in patients who have lost all arm access sites; they should be placed in preference to tunneled central venous catheters.
journal_name
Semin Dialjournal_title
Seminars in dialysisauthors
Abreo KD,Ram SJdoi
10.1111/j.1525-139X.2009.00613.xsubject
Has Abstractpub_date
2009-09-01 00:00:00pages
469-71issue
5eissn
0894-0959issn
1525-139Xpii
SDI613journal_volume
22pub_type
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journal_title:Seminars in dialysis
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