Primary Article

Complications of Lower Extremity Arteriovenous Grafts in Patients With End-Stage Renal Disease

Authors: KRISTINA M. VOGEL, MD, MARTIN A. MARTINO, MD, SEAN P. O'BRIEN, MD, MORRIS D. KERSTEIN, MD

Abstract

Background.More data are needed to assess lower extremity angioaccess sites for hemodialysis. Methods.We did a retrospective review of 843 consecutive hospital records of upper and lower extremity arteriovenous (AV) fistulas from 1992 to 1996. Results.Lower extremity grafts accounted for 16% (134/843) of patients in this series. Complications occurred in 58 of 134 patients (43%) and were more prevalent in women, blacks, diabetic, and hypertensive patients, but not of statistical significance. Dialysis was done for a mean duration of 13.3 years, with a mean graft patency rate of 13.8 months. The 12-month survival rate of lower extremity AV grafts was 62% (83/134). Complications in the lower extremity AV graft group (58 patients) included infections in 27 patients (46%), thrombosis within 30 days in 16 (28%), pseudoaneurysm in 9 (16%), and graft hemorrhage in 6 (10%). Conclusions.There is a decreased patency rate in lower extremity AV grafts.

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