Document Detail

Graftula: a composite access consisting of a graft used to repair a dysfunctional hemodialysis fistula.
MedLine Citation:
PMID:  23004012     Owner:  NLM     Status:  MEDLINE    
Nonmaturing or dysfunctional hemodialysis fistulas are often repaired with interposition grafts placed either within the fistula (fistula-to-fistula configuration), or connected to another vein (fistula-to-vein configuration). The goal of this study was to compare the survival and usefulness of the composite accesses thus created, which we call "graftulas," with upperarm grafts. This was a retrospective study wherein we determined the survival and thrombosis rates of graftulas (n=24) and upper arm grafts (n=31) placed 1/1/07 through 12/31/09 and followed through 11/30/10. Graftulas resembled grafts as most (96%) were successfully cannulated in 65 ± 43 days. Survival of graftulas was also similar to grafts (58%, 47%, and 32% vs. 56%, 47%, and 39% at 1, 2, and 3 years respectively, p=0.60). However, graftulas had a lower thrombosis rate than grafts (0.5 vs. 1.2 per patient year, p=0.04), and in the fistula-to-fistula configuration, a 2-year thrombosis-free survival of 78%. Total survival of the access site (fistula+graftula) was 92%, 73%, and 42% at 1, 3, and 5 years, respectively. Graftulas possess certain beneficial properties of fistulas and grafts that allows for continued use of the original access site.
Karthik Ramani; Ajay Kallam; Gazi Zibari; Gloria Caldito; Sunanda J Ram; Kenneth D Abreo; Adrian Sequeira
Publication Detail:
Type:  Journal Article     Date:  2012-09-25
Journal Detail:
Title:  Seminars in dialysis     Volume:  26     ISSN:  1525-139X     ISO Abbreviation:  Semin Dial     Publication Date:    2013 May-Jun
Date Detail:
Created Date:  2013-05-17     Completed Date:  2014-02-20     Revised Date:  2014-05-05    
Medline Journal Info:
Nlm Unique ID:  8911629     Medline TA:  Semin Dial     Country:  United States    
Other Details:
Languages:  eng     Pagination:  355-60     Citation Subset:  IM    
Copyright Information:
© 2012 Wiley Periodicals, Inc.
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MeSH Terms
Arm / blood supply*
Arteriovenous Shunt, Surgical / adverse effects*
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / methods*
Graft Occlusion, Vascular / surgery*
Graft Survival
Middle Aged
Prospective Studies
Renal Dialysis*
Treatment Outcome
Vascular Patency
Venous Thrombosis / surgery*
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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