APL) as an alternative permanent vascular access in strictly selected patients with end-stage renal disease.
Methods: This single-center prospective observational study was conducted between January 2014 and June 2017 and
included 89 brachial AAPL procedures. Primary, assisted primary, and secondary patency rates were calculated using
Kaplan-Meier analysis.
Results: Exhausted peripheral veins were the most common indication for brachial AAPL. Patients were followed up for a
mean period of 28.7 6 4.9 months. Nineteen grafts developed thrombosis, 13 grafts developed pseudoaneurysms, 9 grafts
developed hematoma, and 6 grafts were abandoned because of infection. The primary, assisted primary, and secondary
patency rates were 62% 6 5.2%, 71.2% 6 4.9%, and 89.6% 6 3.3% at 24 months, respectively.
Conclusions: Brachial AAPL can offer a simple, safe, and efficient alternative as a permanent hemodialysis access in
a selected subset of end-stage renal disease patients, with acceptable durability and rate of complications. Because
of its unique specifications, cooperation between vascular surgeons and dialysis staff is mandatory. (J Vasc Surg
2020;72:181-7.)
Keywords: Arterio-arterial; Alternative dialysis access; Brachial artery prosthetic loop; Exhausted peripheral veins; Central
venous occlusive disease