title: Early cannulation grafts in straight axillo-axillary angioaccesses avoid central catheter insertions.
abstract: The need for early cannulation grafts exists to prevent use of central venous catheters. We report our experience in patients who had a straight axillo-axillary angioaccess. All patients who have undergone an early cannulation axillo-axillary angioaccess between 2008 and 2010 were reviewed. Fifteen patients had 16 procedures. Of these, eight were women and their mean age was 56. All patients had exhausted access options bilaterally. All had previous catheter insertions with either sepsis or jugular veins thrombosis. They all had an axillary artery to axillary vein angioaccess using an early cannulation graft. Flixene(®) (Atrium Medical, Hudson, NH, USA) was used in 10 cases, whereas Rapidax(®) (Vascutek Ltd., Renfrewshire, UK) in 6. In 12 cases, grafts were cannulated after 12 hours, in 4 after 24 hours (12 hours-8 days, mean 1.8 days). For Flixene(®) , mean delay to cannulation was 1.1 days, whereas 2.71 for Rapidax(®) (p < 0.05). Primary patency rates were 92.9% and 65.7% at 6 weeks and 1 year, respectively. Secondary patency rates were 92.9% and 83.5%. There was no significant difference in patency rates between grafts. Early cannulation grafts in a complex position are safe and efficient considering their patency and complication rates. It avoids using central venous catheters.
authors.affiliation: Renal Transplant and Vascular Access Unit, St. George's Healthcare NHS Trust, London, United Kingdom. eric.chemla@stgeorges.nhs.uk
authors.forename: Eric S
authors.initials: ES
authors.lastname: Chemla
authors.forename: Steve
authors.initials: S
authors.lastname: Nelson
authors.forename: Mohamed
authors.initials: M
authors.lastname: Morsy
mesh_terms: D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D001366:Axillary Artery / Q000601:surgery*; D001367:Axillary Vein / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002404:Catheterization; D002405:Catheterization, Central Venous; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult