title: Experience of HeRO dialysis graft placement in a challenging population.
abstract: OBJECTIVE
  To assess the outcomes of the hemodialysis reliable outflow (HeRO) device in a subset of hemodialysis access-challenged patients with central venous obstruction.
  
  
  METHODS
  Retrospective analysis of a series of patients in 2 centers who underwent placement of the HeRO device between September 2009 and November 2010. Patients' demographics, access history, HeRO patency, and number of reinterventions were analyzed.
  
  
  RESULTS
  Eleven patients underwent 12 HeRO implantations. The average duration of dialysis prior to HeRO placement was 5.55 ± 3.64 years. Primary and secondary patencies at 6 months and 1 year were 36.4% and 54.5% and 9.1% and 45.5%, respectively.
  
  
  CONCLUSIONS
  In the end-stage renal disease population with central venous occlusive disease, the HeRO device offers the best long-term dialysis option when an arteriovenous fistula or graft is not possible. Close follow-up and subsequent aggressive interventions can prolong the use of the HeRO and avoid the last resort of dialysis catheters.
authors.affiliation: The Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Angela A
authors.initials: AA
authors.lastname: Kokkosis
authors.forename: Steven D
authors.initials: SD
authors.lastname: Abramowitz
authors.forename: Jonathan
authors.initials: J
authors.lastname: Schwitzer
authors.forename: Harry
authors.initials: H
authors.lastname: Schanzer
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Teodorescu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000295:instrumentation*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D061807:Catheter Obstruction; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation; D002408:Catheters, Indwelling; D062905:Central Venous Catheters; D004867:Equipment Design; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D006435:Renal Dialysis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: HeRO; arteriovenous graft; central venous obstruction; central venous occlusion; hemodialysis