Outcomes of Stent Grafts for Treating Thrombosed Thigh Arteriovenous Grafts

Introduction: Arteriovenous thigh grafts (AVGs) are often complicated with stenotic lesions at the vein-graft anastomosis site and subsequent graft thrombosis, compromising the lifespan of the dialysis access. Our study sought to investigate the role of stenting as a predictor of the thigh AVG overall survival.

Method(s): A retrospective review of 407 thigh AVGs created in 306 dialysis-dependent patients between 1998 and 2020 was completed. Both primary AVG survival (from graft placement to the first intervention) and secondary AVG survival (from graft placement to permanent failure/abandonment) were calculated. Survival rates were estimated using Kaplan–Meier survival analysis. Multivariate analysis was performed to determine secondary graft patency predictors.

Result(s): Median cumulative secondary graft survival in the stent versus no-stent groups was 86.1 (±15.5) versus 34.1 (±5.3) months (p = 0.001), respectively. Use of stenting in thrombosed AVG was associated with better secondary patency [HR 0.6 (0.4± 0.9); p = 0.008] as compared with no stenting/no thrombosis group.

Conclusion(s): Stent grafts could improve overall secondary AVG survival specially in thrombosed grafts. Further prospective randomized studies are needed to validate these findings.

Publication History

Article published online:
09 February 2023