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Application of m shape arterio-venous access graft for hemodialysis in very obese patients with native short length arm

Author: 
Seyed Mansour Alamshah and Mozhgan Sametzadeh
Subject Area: 
Health Sciences
Abstract: 

Introduction: Since a decade ago, M shape hem dialysis access had been created in our department for patients with native short length arms. Short arm obese and very obese patients also are the rare main targets for its application. Method: This is a case control series study of9obese patients, 2 males and 7 females (BMI≥40, mean=44.80) (6 cases obese class III, 3 cases class II, mean weight=105.55 Kg)who were referred for hem dialysis access. They had short length arm and were selected during 32months. Expanded polytetrafluoroethylen was used for M shape Brachial-Axillary access under regionalor local anesthesia. Primary and secondary patency (3,6, 12 months) was followed and patients were compared to the other non-obese control group for patency, effective length and graft outgoing flow. One-year follow up has been considered. Results: Of nine patients, 6female patients were diabetics. Mean effective length of arms was 16.21Cm, (P=0.001). Patients have effective hem dialysis during primary and secondary follow up. In comparison with straight grafts, color Doppler was shown no considerable velocity difference due to the spiral status (P= 0.877 arterial outflow, P=0.625 venous outflow). Primary patency was 100%, secondary patency in 3, 6, 12 months were 88%, 55.56% and 44% respectively. Conclusion: M shape arterio-venous graft access was shown efficient for obese and very obese withnative bi-articularshort length arms with or without diabetes that conventional access techniques are not feasible. Dialysis ought to perform by educated familiarized staff.

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