Patency rate and complications of vascular access grafts for hemodialysis in lower extremities

Placement of thigh grafts is an option in hemodialysis (HD) patients who have exhausted all upper extremity sites for permanent vascular access. To determine patency rate and complications of lower extremity grafts used for vascular access in patients on chronic HD in our center we studied prospectively the outcomes of 41 thigh grafts placed at a single institution during a 4-yr period (January 2000 and July 2003). Information was recorded on surgical complications and date of graft failure. The mean patient age was 55 ± 12 years and 54% of the patients were males. The primary patency rates were, 76%, 67%, and 60% at 3, 9, and 12 months, respectively. There were 10 (24.4%) patients with thrombosis and 2 (4.8%) patients with bleeding. Graft infec­tion and pseudoaneurism were observed in 2 patients each. No significant differences in infection rate or graft patency rates were found by patient age and gender. In our experiences, lower extremity vascular access graft is not associated with higher morbidity. Lower extremity polytetrafluoroethylene vascular graft (ePTFE) seems to be an appropriate vascular access when arteriovenous fistulas and upper extremity grafts cannot be constructed.