Brachial Artery Loop versus Axillary Artery Loop Grafts as Unusual Hemodialysis Angioaccess

Document Type : Original Article

Authors

1 Department of Vascular Surgery, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt

2 Department of General Surgery, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt

Abstract

Background: Significant improvements have been made in the quality of care and life expectancy for patients on dialysis over the past decade. Consequently, it is not uncommon to be confronted with patients exhausted by conventional vascular access methods and in need for unusual vascular access to maintain hemodialysis, so arterio-arterial prosthetic loops can offer an alternative option for these patients.
Aim of the work: The purpose of this study is to evaluate and compare two arterio-arterial loop procedures, using the brachial artery in the arm and the axillary artery on the chest wall.
Patients and Methods: This study was conducted as a retrospective non-randomized comparative study between two groups of patients. The first group [group A] included 14 patients subjected to brachial artery loop graft in the arm [BALG], while the second group [group B] included 23 patients subjected to axillary loop graft on the chest wall [AALG].
Results: Statistically significant differences were achieved between the two groups concerning operative time, blood loss, and hospital stay, where the mean operative time was 89.7 ± 5.16 minutes in group A, the mean blood loss was 117.9 ± 31.7 ml, and the mean hospital stay was 3.5 ± 0.71 days; While in group B, Mean operative duration was 122.2 ± 8.45 minutes, mean blood loss was 228.6 ±51.4 ml, and mean hospital stay was 5.29 ± 0.52 days.
Conclusion: The brachial artery loop graft is superior to the axillary artery loop graft and should be a prioritized option when arterial loop access is indicated.

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