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Effect of Timing of the First Cannulation on Survival of Arteriovenous Hemodialysis Grafts
Authors:Leonid Feldman  Michal Shani  Jabir Mursi  Ilia Beberashvili  Arie Bass  Joshua Weissgarten  Igor Rabin
Affiliation:1. Nephrology Department and Vascular Surgery Department, Assaf Harofeh Medical Center, Zerifin;2. Sackler School of Medicine, Tel‐Aviv University, Tel Aviv, Israel;3. Department of Family Medicine, Clalit Health Services, Rishon le Zion
Abstract:The use of an arteriovenous graft as vascular access for hemodialysis is associated with a high rate of patency loss. The influence of timing of the first cannulation of the graft on graft survival has not been sufficiently studied. The purpose of this study was to investigate an association between the timing of the first cannulation of the polytetrafluoroethylene arteriovenous graft and the incidence of 12‐month failure. This is a retrospective study on a cohort of chronic hemodialysis patients treated in a single center. According to the time, in weeks, between graft construction and its first successful cannulation, the grafts were divided into six groups: 2nd, 3rd, 4th, 5th, 6th and 7th or more week after surgery. The primary outcome was primary graft failure at 12 months, defined as the first occurrence of graft thrombosis or any invasive access procedure. The secondary outcome was cumulative graft failure at 12 months, defined as complete loss of the access site for dialysis. Fifty‐eight patients with 64 newly‐created arteriovenous grafts were included in the study. In the whole cohort, the incidence of primary graft failure at 12 months was 72.2%, and the incidence of cumulative graft failure at 12 months was 40.7%. The incidences of primary graft failure and cumulative graft failure at 12 months did not differ significantly between the study groups. In our study, timing of the first cannulation of a new arteriovenous polytetrafluoroethylene graft had no significant impact on graft survival.
Keywords:Arteriovenous graft  Cannulation  Graft failure  Hemodialysis  Vascular access
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