Comparison of clinical application between lower and upper extremity arteriovenous grafts

Objective To compare the postoperative patency rate, dialytic adequacy and complications of lower/upper extremity arteriovenous grafts(AVGs) in hemodialysis patients to provide reference for establishing AVGs in lower extremities. Methods During April 2015 and April 2020, a retrospective review of extremity AVGs was performed for 47 hemodialysis(HD) patients. Clinical data, postoperative patency rate, dialytic adequacy and complications were analyzed. Results A total of 47 extremity AVGs were selected. The locations were lower(n=17) and upper(n=30) extremities. No significant inter-group difference existed in general data(P>0.05). At Month 3/6/9/12, primary patency rates of lower extremity AVGs were 94.12%, 76.47%, 76.47% and 70.59% and assisted primary patency rates 94.12%, 88.24%, 88.24% and 82.35% respectively. And all secondary patency rates were 100.00%. The primary patency rates of upper extremity AVGs were 100.00%, 96.67%, 83.33% and 73.33%, assisted primary patency rates 100.00%, 100.00%, 90.00% and 80.00% and secondary patency rates 100.00%, 100.00%, 96.67% and 96.67% respectively(P₁=0.231, P₂=0.837, P₃=0.833). Dialytic adequacy was not significantly different between two groups(P>0.05). The incidence of stenosis in lower extremity AVGs was higher than that in upper extremity AVGs(83.87% versus 60.71%, P<0.05). Conclusion As an alternative site of AVG, the clinical efficacy of lower extremity AVG is similar to that of upper extremity.