Immediate-access grafts provide comparable patency to standard grafts, with fewer reinterventions and catheter-related complications.


BACKGROUND:No independent comparisons, with midterm follow-up, of standard arteriovenous grafts (SAVGs) and immediate-access arteriovenous grafts (IAAVGs) exist. The goal of this study was to compare "real-world" performance of SAVGs and IAAVGs. METHODS:Consecutive patients who underwent placement of a hemodialysis graft between November 2014 and April 2016 were retrospectively identified from the electronic medical record and Vascular Quality Initiative database at two tertiary centers. Only primary graft placements were included for analysis. Patients were divided into two groups based on the type of graft implanted. Patients' comorbidities, graft configuration, operative characteristics, and follow-up were collected and analyzed with respect to primary and secondary patency. Additional outcomes included graft-related complications, time to first cannulation, time to tunneled catheter removal, catheter-related complications, and overall survival. Patency was determined from the time of the index procedure; χ2, Kaplan-Meier, and Cox regression analyses were used, with the P value set as significant at < .05. RESULTS:There were 210 grafts identified, 148 SAVGs and 62 IAAVGs. At baseline, the patients' characteristics were similar between groups, except for a greater prevalence of preoperative central venous occlusions in the IAAVG group (16.3% vs 6.8%; P < .04). Of the IAAVG group, 50 were Acuseal (W. L. Gore & Associates, Flagstaff, Ariz) and 12 were Flixene (Atrium Medical Corporation, Hudson, NH). Primary patency was similar at both 1 year (SAVG, 39.4%; IAAVG, 56.7%; P = .4) and 18 months (SAVG, 29.0%; IAAVG, 43.7%; P = .4). Secondary patency was similar at 1 year (SAVG, 50.7%; IAAVG, 52.1%; P = .73) and 18 months (SAVG, 42.3%; IAAVG, 46.3%; P = .73). Overall survival was 48% at 24 months. IAAVG patients required fewer overall additional procedures to maintain patency (mean number of procedures, 0.99 for SAVGs vs 0.61 for IAAVGs; P = .025). There was no difference in occurrence of steal syndrome (SAVG, 6.8%; IAAVG, 8.1%; P = .74) or graft infection (SAVG, 19.0%; IAAVG, 12.0%; P = .276). Seventy-five percent of all grafts were successfully cannulated, with shorter median time to first cannulation in the IAAVG group (6 days; interquartile range [IQR], 1-19 days) compared with the SAVG group (31 days; IQR, 26-47 days; P < .01). Of all pre-existing catheters, 65.75% were removed, with a shorter median time until catheter removal in the IAAVG cohort at 34 days (IQR, 22-50 days) vs 49 days (IQR, 39-67 days) in the SAVG group (P < .01). Catheter-related complications occurred less frequently in the IAAVG group (16.4% vs 2.9%; P < .045). CONCLUSIONS:IAAVGs allow earlier cannulation and tunneled catheter removal, thereby significantly decreasing catheter-related complications. Patency and infection rates were similar between SAVGs and IAAVGs, but fewer secondary procedures were performed in IAAVGs.


J Vasc Surg


Wagner JK,Dillavou E,Nag U,Ali AA,Truong S,Chaer R,Hager E,Yuo T,Makaroun M,Avgerinos ED




Has Abstract


2019-03-01 00:00:00














  • Amputation-free survival, limb symptom alleviation, and reintervention rates after open and endovascular revascularization of femoropopliteal lesions in patients with chronic limb-threatening ischemia.

    abstract:BACKGROUND:The optimal strategy for revascularization in chronic limb-threatening ischemia (CLTI) is not yet completely known and is still under debate. Endovascular treatment methods predominate despite limited evidence for their advantage. In this concurrent, prospective observational cohort study, we investigated ou...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Perlander A,Jivegård L,Nordanstig J,Svensson M,Österberg K

    更新日期:2020-12-01 00:00:00

  • Use and limitations of thrombolytic therapy in the treatment of peripheral arterial ischemia: results of a multi-institutional questionnaire.

    abstract::In an attempt to assess the efficacy of thrombolytic infusions for arterial ischemia, a questionnaire was distributed to 142 vascular surgeons. Data from 45 respondents who had experience with thrombolytic infusion in 623 patients were reviewed. A successful outcome was obtained in 313 of 623 patients (50.2%). Morbidi...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Ricotta JJ,Green RM,DeWeese JA

    更新日期:1987-07-01 00:00:00

  • Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous veins (VeClose).

    abstract:BACKGROUND:Whereas thermal ablation of incompetent saphenous veins is highly effective, all heat-based ablation techniques require the use of perivenous subfascial tumescent anesthesia, involving multiple needle punctures along the course of the target vein. Preliminary evidence suggests that cyanoacrylate embolization...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Morrison N,Gibson K,McEnroe S,Goldman M,King T,Weiss R,Cher D,Jones A

    更新日期:2015-04-01 00:00:00

  • The effects of extremely low shear stress on cellular proliferation and neointimal thickening in the failing bypass graft.

    abstract:OBJECTIVE:Previous studies demonstrating a correlation between low shear stress (tau = 5-15 dyne/cm(2)) and experimental vein graft neointimal thickening (NIT) support the role of low tau in vein graft failure. However, a simple linear relationship between low tau and NIT would underestimate the degree of NIT evident i...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Meyerson SL,Skelly CL,Curi MA,Shakur UM,Vosicky JE,Glagov S,Schwartz LB,Christen T,Gabbiani G

    更新日期:2001-07-01 00:00:00

  • Flush saphenofemoral ligation and multiple stab phlebectomy preserve a useful greater saphenous vein four years after surgery.

    abstract:PURPOSE:Flush saphenofemoral ligation, with multiple cosmetic stab phlebectomy, successfully treats saphenofemoral reflux and superficial varicosities. The long-term effect on the residual greater saphenous vein (GSV) requires evaluation. METHODS:Noninvasive triplex ultrasound assessment of the residual GSV for potent...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Fligelstone LJ,Salaman RA,Oshodi TO,Wright I,Pugh N,Shandall AA,Lane IF

    更新日期:1995-11-01 00:00:00

  • Return to well-being and function after infrainguinal revascularization.

    abstract:PURPOSE:The purpose of this study was to assess functional status, well-being, and symptom relief of patients after infrainguinal revascularization for severe peripheral vascular disease. METHODS:Two questionnaires were used to assess symptoms, functional status, and well-being before operation and 6 months after oper...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Gibbons GW,Burgess AM,Guadagnoli E,Pomposelli FB Jr,Freeman DV,Campbell DR,Miller A,Marcaccio EJ Jr,Nordberg P,LoGerfo FW

    更新日期:1995-01-01 00:00:00

  • Cryopreserved arterial allograft reconstruction for peripheral graft infection.

    abstract:OBJECTIVE:This prospective, observational study evaluated the safety and efficacy of cryopreserved arterial allograft reconstruction in the management of major peripheral arterial graft infections. METHODS:From April 1996 to May 2003, data from patients with major peripheral arterial graft infection who underwent graf...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Castier Y,Francis F,Cerceau P,Besnard M,Albertin J,Fouilhe L,Cerceau O,Albaladejo P,Lesèche G

    更新日期:2005-01-01 00:00:00

  • Stenting of vertebrobasilar arteries in symptomatic atherosclerotic disease and acute occlusion: case series and review of the literature.

    abstract:PURPOSE:Two of three patients with vertebrobasilar stroke harbor a stenosis of the vertebral or basilar arteries. The best treatment for secondary prophylaxis in vertebrobasilar occlusive disease has not been defined. In patients with high-grade stenoses, and especially those refractory to medication, stenting offers t...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,评审


    authors: Eberhardt O,Naegele T,Raygrotzki S,Weller M,Ernemann U

    更新日期:2006-06-01 00:00:00

  • Application of a homemade stent graft to the pulmonary arteries in a patient with total cavopulmonary connection.

    abstract::Despite increasing popularity in the use of stent grafts to treat aortic diseases, stent grafts are used for pulmonary arterial lesions less frequently. In particular, to our knowledge no report has described stent graft implantation into the pulmonary arteries in patients with total cavopulmonary connection (Fontan o...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Adachi I,Kuratani T,Shirakawa Y,Ueno T,Matsumiya G,Sawa Y

    更新日期:2010-05-01 00:00:00

  • Overall outcome after endovascular aneurysm repair with a first-generation stent graft (Vanguard): A 20-year single-center experience.

    abstract:OBJECTIVE:The problems with first-generation stent grafts for endovascular aneurysm repair are well known, but their long-term outcome remains to be established. The purpose of the study was to characterize the outcome of patients treated for abdominal aortic aneurysm (AAA) with a first-generation stent graft, Vanguard...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Väärämäki S,Salenius J,Pimenoff G,Uurto I,Suominen V

    更新日期:2020-09-01 00:00:00

  • Increased vascularization of shoulder regions of carotid atherosclerotic plaques from patients with diabetes.

    abstract:OBJECTIVE:Increased vascularization is considered an important contributing factor for plaque vulnerability. Microvascular proliferative disease in patients with diabetes results in renal damage and visual loss. We assessed the hypothesis that vascularization in carotid atherosclerotic tissue is increased in diabetic p...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Olson FJ,Strömberg S,Hjelmgren O,Kjelldahl J,Fagerberg B,Bergström GM

    更新日期:2011-11-01 00:00:00

  • Hyperglycemia limits experimental aortic aneurysm progression.

    abstract:OBJECTIVE:Diabetes mellitus (DM) is associated with reduced progression of abdominal aortic aneurysm (AAA) disease. Mechanisms responsible for this negative association remain unknown. We created AAAs in hyperglycemic mice to examine the influence of serum glucose concentration on experimental aneurysm progression. ME...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Miyama N,Dua MM,Yeung JJ,Schultz GM,Asagami T,Sho E,Sho M,Dalman RL

    更新日期:2010-10-01 00:00:00

  • Diameter changes in isolated iliac artery aneurysms 1 to 6 years after endovascular graft repair.

    abstract:OBJECTIVE:Precise diameter changes in iliac artery aneurysms (IAAs) after endovascular graft (EVG) repair are yet to be determined. This report describes the midterm size changes in isolated IAAs 13 to 72 months after treatment with an EVG. METHODS:From January 1993 to April 1999, 31 patients with 35 true isolated IAA...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Sahgal A,Veith FJ,Lipsitz E,Ohki T,Suggs WD,Rozenblit AM,Cynamon J,Wain RA

    更新日期:2001-02-01 00:00:00

  • High hemoglobin A1c associated with increased adverse limb events in peripheral arterial disease patients undergoing revascularization.

    abstract:OBJECTIVE:Diabetes and peripheral arterial disease (PAD) are independently associated with increased risk of amputation. However, the effect of poor glycemic control on adverse limb events has not been studied. We examined the effects of poor glycemic control (high hemoglobin A1c level) on the risk of amputation and mo...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Arya S,Binney ZO,Khakharia A,Long CA,Brewster LP,Wilson PW,Jordan WD Jr,Duwayri Y

    更新日期:2018-01-01 00:00:00

  • Prognostic scoring in ruptured abdominal aortic aneurysm: a prospective evaluation.

    abstract:BACKGROUND:Prospective validation of prognostic scoring systems for ruptured abdominal aortic aneurysm (AAA) is lacking. This study assesses the validity of three established risk scores and a new prognostic index. METHOD:Patients admitted with ruptured AAA during a 26-month period (August 2002-December 2004) were rec...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Tambyraja AL,Lee AJ,Murie JA,Chalmers RT

    更新日期:2008-02-01 00:00:00

  • Endovascular obliteration of saphenous reflux: a multicenter study.

    abstract:OBJECTIVE:The objective of this study was to assess the differences in clinical outcomes in patients treated with endovenous saphenous vein obliteration with technical outcome of either complete occlusion (CO), near complete occlusion (NCO), defined as < or =5-cm segment of flow in treated vein, or recanalization, defi...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,多中心研究


    authors: Merchant RF,DePalma RG,Kabnick LS

    更新日期:2002-06-01 00:00:00

  • Contained rupture of the suprarenal aorta.

    abstract::A contained rupture of the aorta is a rare event; however, this has been recognized with increased frequency in the abdominal aorta. There have previously been two reports of the containment of rupture of the suprarenal aorta. We report two additional cases of contained rupture of the suprarenal aorta, one caused by a...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Nora JD,Hollier LH

    更新日期:1987-04-01 00:00:00

  • Recanalization of flush iliac occlusions with the assistance of a contralateral iliac occlusive balloon.

    abstract::Treating flush iliac artery occlusion by endovascular means can be very challenging and is a cause of technical failure requiring open surgical intervention. We describe a simple endovascular technique that can be valuable in increasing technical success and avoiding the use of a re-entry device. The technique involve...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Bechara CF,Barshes NR,Lin PH,Kougias P

    更新日期:2012-03-01 00:00:00

  • Cerebrospinal fluid drainage to prevent paraplegia during thoracic and thoracoabdominal aortic aneurysm surgery: a systematic review and meta-analysis.

    abstract:OBJECTIVES:We undertook a quantitative systematic review of randomized controlled trials (RCTs) and observational studies to determine the effectiveness of cerebrospinal fluid (CSF) drainage to prevent paraplegia in thoracic aneurysm (TA) and thoracoabdominal aortic aneurysm (TAAA) surgery. METHODS:We included RCTs an...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,meta分析,评审


    authors: Cinà CS,Abouzahr L,Arena GO,Laganà A,Devereaux PJ,Farrokhyar F

    更新日期:2004-07-01 00:00:00

  • Flexible robotics with electromagnetic tracking improves safety and efficiency during in vitro endovascular navigation.

    abstract:OBJECTIVE:One limitation of the use of robotic catheters is the lack of real-time three-dimensional (3D) localization and position updating: they are still navigated based on two-dimensional (2D) X-ray fluoroscopic projection images. Our goal was to evaluate whether incorporating an electromagnetic (EM) sensor on a rob...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Schwein A,Kramer B,Chinnadurai P,Walker S,O'Malley M,Lumsden A,Bismuth J

    更新日期:2017-02-01 00:00:00

  • Mortality and complications after aortic bifurcated bypass procedures for chronic aortoiliac occlusive disease.

    abstract:OBJECTIVE:Open surgery has given way to endovascular grafting in patients with aortoiliac occlusive disease. The growing use of endovascular grafts means that fewer patients with aortoiliac occlusive disease have open surgery. The declining open surgery caseload challenges the surgeon's operative skills, particularly b...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Bredahl K,Jensen LP,Schroeder TV,Sillesen H,Nielsen H,Eiberg JP

    更新日期:2015-07-01 00:00:00

  • Development and evaluation of the Walking Estimated-Limitation Calculated by History questionnaire in patients with claudication.

    abstract:BACKGROUND:The Walking Impairment Questionnaire (WIQ) is used to estimate walking impairment in patients with peripheral artery disease; however, it faces frequent errors when self-completed and is complex to score. We aimed to validate an alternative, easily scored four-item tool, the Walking Estimated-Limitation Calc...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,多中心研究


    authors: Ouedraogo N,Chanut M,Aubourg M,Le Hello C,Hidden V,Audat G,Harbonnier M,Abraham P

    更新日期:2013-10-01 00:00:00

  • Endovascular treatment of spontaneous dissections of the superior mesenteric artery.

    abstract:BACKGROUND:Spontaneous dissection of the superior mesenteric artery (SMA) is exceedingly rare. Treatment options range from observation to anticoagulation to open surgery or endovascular repair. We present our experience to date in the management of isolated SMA dissections. METHODS:A retrospective review of the vascu...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,评审


    authors: Gobble RM,Brill ER,Rockman CB,Hecht EM,Lamparello PJ,Jacobowitz GR,Maldonado TS

    更新日期:2009-12-01 00:00:00

  • Randomized comparison of percutaneous Viabahn stent grafts vs prosthetic femoral-popliteal bypass in the treatment of superficial femoral arterial occlusive disease.

    abstract:OBJECTIVE:This randomized prospective study was designed to compare the effectiveness of treating superficial femoral artery occlusive disease percutaneously with expanded polytetrafluoroethylene (ePTFE)/nitinol self-expanding stent grafts vs surgical femoral-to-above knee (AK) popliteal artery bypass with synthetic gr...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,随机对照试验


    authors: Kedora J,Hohmann S,Garrett W,Munschaur C,Theune B,Gable D

    更新日期:2007-01-01 00:00:00

  • Cost-effectiveness of intensive smoking cessation therapy among patients with small abdominal aortic aneurysms.

    abstract:INTRODUCTION:Smoking cessation is one of the few available strategies to decrease the risk for expansion and rupture of small abdominal aortic aneurysms (AAAs). The cost-effectiveness of an intensive smoking cessation therapy in patients with small AAAs identified at screening was evaluated. METHODS:A Markov cohort si...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Mani K,Wanhainen A,Lundkvist J,Lindström D

    更新日期:2011-09-01 00:00:00

  • Choice of a second vascular access in hemodialysis patients whose initial arteriovenous fistula failed to mature.

    abstract:OBJECTIVE:We have previously shown that arteriovenous fistulas (AVFs) are more expensive to create and to maintain than arteriovenous grafts (AVGs) in patients undergoing their first access. Because those for whom this first access fails may be a more disadvantaged group, we hypothesized that the cost of a second acces...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Al-Balas A,Lee T,Young CJ,Allon M

    更新日期:2018-12-01 00:00:00

  • Outcomes following infrapopliteal angioplasty for critical limb ischemia.

    abstract:OBJECTIVE:Infrapopliteal angioplasty (percutaneous transluminal angioplasty [PTA]) is routinely used to treat critical limb ischemia (CLI) despite limited data on long-term outcomes. METHODS:We reviewed all patients undergoing infrapopliteal PTA for CLI from 2004 to 2012 stratified by TransAtlantic Inter-Society Conse...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Lo RC,Darling J,Bensley RP,Giles KA,Dahlberg SE,Hamdan AD,Wyers M,Schermerhorn ML

    更新日期:2013-06-01 00:00:00

  • The influence of prototype testing in three-dimensional aortic models on fenestrated endograft design.

    abstract:OBJECTIVE:The fenestrated Anaconda endograft (Vascutek/Terumo, Inchinnan, UK) is intended for the treatment of abdominal aortic aneurysms with an insufficient infrarenal landing zone. The endografts are custom-made with use of high-resolution, 1-mm-slice computed tomography angiography images. For every case, a nonster...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Taher F,Falkensammer J,McCarte J,Strassegger J,Uhlmann M,Schuch P,Assadian A

    更新日期:2017-06-01 00:00:00

  • The correlation between computed tomography and duplex evaluation of autogenous vein bypass grafts and their relationship to failure.

    abstract:OBJECTIVE:Duplex ultrasound (DUS) imaging for vein bypass graft (VBG) surveillance is confounded by technical and physiologic factors that reduce the sensitivity for detecting impending graft failure. In contrast, three-dimensional computed tomography angiography (CTA) offers high-fidelity anatomic characterization of ...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Rehfuss J,Scali S,He Y,Schmit B,Desart K,Nelson P,Berceli S

    更新日期:2015-12-01 00:00:00

  • A prospective evaluation of atherosclerotic risk factors and hypercoagulability in young adults with premature lower extremity atherosclerosis.

    abstract:PURPOSE:Fifty-one consecutive patients with premature lower extremity atherosclerosis were prospectively evaluated for atherogenic risk factors and primary or acquired hypercoagulability, which might contribute to early ischemia and revascularization failure. METHODS:Laboratory tests included plasma assays of (1) natu...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Levy PJ,Gonzalez MF,Hornung CA,Chang WW,Haynes JL,Rush DS

    更新日期:1996-01-01 00:00:00