Table 2.
Studies evaluating the long-term results of lower extremity arteriovenous grafts
| Study | Access | Patients, n | No. of AV Accesses | Age in yr, Median (Range) | Sex N (Men) | Ethnicity (Black) | Diabetes N | Follow-Up, d, Median (Range) | Cumulative AV Access Primary Patency at 2 yr | Infection: All Episodes, % (Episodes per Dialysis Patient-Yr) | Reason for Abandonment (Infection) | Thrombosis (Episodes per Dialysis Patient-Yr)/Need AVG Removal | Early Graft/AVF Failure | Steal: All Episodes n, %/Requiring Closure of Access |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Slater and Raftery 1988 (20) | LE-AVG | 21 | 22 | 50 (18–74) | NA | NA (NA) | NA | 365 | 12 (80.5%) | 3 (15) | 0 | 2 (9.1) | 4 (18.2) | 0/NA |
| Taylor et al. 1996 (22): PTFE, 39; BMV, 6 | LE-AVG | 39 | 45 | 58 (26–82) | 16 (41) | 24 (61.5%) | 11 (28.2%) | 550 | 21 (47%) | 8 (18%) | 5 (11.1%) | (35 episodes) 15 (33%)/13 (28.9%) | NA | 7 (16%)/1 |
| Khadra et al. 1997 (26): upper thigh | LE-AVG | 61 | 74 | 50.1±15.9 | 21 | 5% | 1190 (340/2 wk) | 38 (62%) (mean =84.6 wk) | 12 (16%) | 10 | 18 (24%) | 2 | 2/2 | |
| Korzets et al. 1998 (6) | LE-AVG | 35 | 37 | 54.6±17.0 (21–78) | 14 | NA | 8 (23%) | NA, 915 (30 mo) | 65% | NA | 2 | (11%) | 3 | 4 (11%)/1 |
| Vogel et al. 2000 (27) | LE-AVG | 134 | 134 | 56 (29–73) | 81 (60%) | 103 (77%) | 26 (19%) | NA | NA (mean =13.8 mo, 55 wk) | 27 (46%) | 14(10%) | 16 (28%) | 16 (28%) | NA |
| Tashjian et al. 2002 (43) | LE-AVG | 73 | 73 | 62 | 32 (43.84%) | 18 (24.66%) | 21 (28.77%) | NA | 83% | 17 (23.3%) | 13 (17.8%) | 52 episodes, 26 (35.6%) | NA | 1 (1.37%)/0 |
| Flarup and Hadimeri 2003 (44): lower thigh | LE-AVG | 11 | 14 | 56 (34–85) | 6 | NA | 1 | NA (54 mo =823) | 18% | 7 | 3 | 5 | NA | NA |
| Miller et al. 2003 (30) | LE-AVG | NA | 63 | NA | 42.9 | 87.1 | 30.6 | 344 graft-yr | 40% | 13 | 7 (11.1%) | 12.7% | 0 | |
| UE AVG | NA | 346 | NA | 37.6 | 88.7 | 56.4 | 7 | 18 (5.2%) | 5.8% | NA | ||||
| P value | P=0.43 | P=0.88 | P≤0.001 | P=0.07 | P=0.05 | |||||||||
| Hazinedaroğlu et al. 2004 (24) | LE-AVG | 15 | 17 | 61.4 (43–75) | 4 (26.7%) | NA | NA | 272 | 6 (37.5%) | 6 (35.3%) | 4 | 0 | 3/1 | |
| LE-FVT | 15 | 15 | 56.4 (17–74) | 2 (13.3%) | NA | NA | 207 | 13 (86.7%) | 4 (26.7%) | 1 | 0 | 5/1 | ||
| P value | P≥0.05 | P≤0.05 (cumulative patency at 1 yr) | P≥0.05 | P≥0.05 | ||||||||||
| Cull et al. 2004 (23) | LE-AVG | 91 (demographics from 100 patients) | 116 | 58 (19–85) | 37 (37%) | 64 (64%) | 44 (44%) | Mean =20 mo | 54% | 48 (41%) | 27 | NA/3 | 18 (15%) | 13 (11%)/2 |
| Scott et al. 2006 (29): midthigh | LE-AVG | 38 | 46 | 57 (33–85) | 16 (42%) | 28 (73%) | 14 (36%) | NA | 43% | NA | 10 (21%) | NA | 7 (15%) | 6 (13%) |
| Englesbe et al. 2006 (45) | LE-AVG | 30 | 30 | 48 (16–77) | 13 (43%) | 12(40%) | 10 (33%) | Mean =23 mo | 9 (26%) | NA | 8 (27%) | 5 (17%) | 5 (17%) | 1(3%) |
| Salimi 2008 (46) | LE-AVG | 41 | 41 | 55±12 | 54% | NA | 5 (12%) | 1 yr data presented | NA | 2 (4.8%) | 0 | 10 (24.4%)/10 (24.4%) | 0 | 0 |
| Geenen et al. 2010 (28) | LE-AVG | 127 | 153 | 52.7±16.3 | 63% | NA | 21 (17%) | 25 mo | 63.8% | 41 (27%) | 26 (17%) | 110 (72%)/22 (14%) | 8 (5.2%) | 2 (1.6%) |
| Gilbert and Gibbs 2011 (8): adductor loop, midthigh | LE-AVG | 16 | 16 | 55 (27–72) | 11 (68.75%) | NA | NA | 18 mo | 6/16 (37.5%) | 2 (12.5%) | NA | 2/0 | 0 | NA |
| Ram et al. 2010 (21) | LE-AVG | NA | 103 | 48.9±1.4 | 30 (29%) | 93(38%) | 42 (39%) | Total 393 patient-yr | 63.2±5.3 | 0.100 (17%) | NA | 0.543 | 3 (3%) | NA |
| AVF | 49 | 48.4±1.9 | 28 (28%) | 43 (17%) | 17 (15%) | 47.4±11.5 | 0.020 | 0.237 | 30 (61%) | |||||
| UE AVG | 116 | 47.6±1.3 | 44 (43%) | 112 (45%) | 55 (48%) | 24.7±4.3 | 0.521 (19%) | 1.457 | 15 (13%) | |||||
| P value | P=0.80 | P<0.01 | P=0.07 | P=0.23 | P=0.47 | P<0.01 | P<0.01 | |||||||
| Ponikvar 2013 (47) | LE-AVG | 31 | 35 | 58.7±14.5 | 15 (43%) | NA | NA | 1207 d, median patency | 74% | NA | 0 | 17 | 3 (8.5%) | /2 (6.5) |
| Steerman et al. 2013 (35): LE-AVG: ePTFE, 15 (68%); BMV, 7 (32%) | LE-AVG | 21 | 22 | 53.2±17 | 6 (30%) | 18 (90%) | 8 (40%) | 13.9 | NA | 0.71 | 3 (13.6) | NA | NA | 1/0 |
| UE HeRO | 59 | 60 | 58.2±14.2 | 29 (49.2%) | 52 (88.1%) | 36 (61.1%) | 11.9 | NA | 0.61 | 2 (3.3) | 1 (1.6) | NA | /1 (1.6) | |
| P value | P=0.19 | P=0.19 | P=0.20 | P=0.08 | Mo, mean | P=0.77 | ||||||||
| Ong et al. 2013 (31) | LE-AVG | NA | 209 | 52±15 | 90 (43%) | 193 (92%) | 101 (48%) | 340 | (54) | 45 (21) | NA | NA | 17(8.1%) | 0 |
| IJ TCC | 472 | 54±15 | 236 (50%) | 357 (76%) | 242 (51%) | 91 | (27) | |||||||
| P value | P=0.11 | P=0.09 | P<0.001 | P=0.48 | P<0.001 | |||||||||
| Kudlaty et al. 2015 (36) | LE-AVG | 35 | 49.1±3.1 | 23(65.7%) | 32 (91.4) | 8 (22.9) | 1.50±1.18 | (19.3) | 10 (29), 0.94 | 5 (29.4) | 35 (53.9)/10 (58.8) | 6 (17.1) | /0 (0) | |
| UE HeRO | 20 | 57.1±4.3 | 9(45) | 16 (80) | 12 (60) | 1.25±0.21 yr | (38.3) | 3 (15), 0.53 | 2 (25) | 23 (48.9)/5 (62.5) | 6 (30) | /1 (12.5) | ||
| P value | P=0.13 | P=0.16 | P=0.01 | P=0.69 | P=0.33 |
An attempt to summarize the results of various studies conducted involving LE-AVG is represented above. Only a few of these studies can be compared directly with one another because of variations in the methods in which the above studies were conducted and their results reported. AV, arteriovenous; AVG, arteriovenous graft; AVF, arteriovenous fistula; LE-AVG, lower extremity arteriovenous graft; NA, not available; PTFE, polytetrafluoroethylene; BMV, bovine mesenteric vein; UE-AVG, upper extremity arteriovenous graft; LE-FVT, lower extremity femoral vein transposition; ePTFE, expanded polytetrafluoroethylene; UE-HeRO, upper extremity Hemodialysis Reliable Outflow device; IJ-TCC, internal jugular tunneled cuffed catheter.