%0 Journal Article
%T The United Kingdom and Ireland experience of the Haemodialysis Reliable Outflow graft for vascular access
%A A Tavakoli
%A D Kingsmore
%A D Ridway
%A J Gilbert
%A James P Hunter
%A N Inston
%A S Sultan
%A S Suttie
%A Simon R Knight
%A T Brown
%J The Journal of Vascular Access
%@ 1724-6032
%D 2019
%R 10.1177/1129729818770588
%X To describe the UK and Ireland experience of the Haemodialysis Reliable Outflow graft in complex vascular access. Observational, multi-centre case series. Data from any patient undergoing Haemodialysis Reliable Outflow graft were collected from eight UK and one Irish centre. Any Haemodialysis Reliable Outflow procedure between July 2013 and May 2016 was included. Demographics, primary and secondary patency rates, and complications were analysed. A total of 52 patients underwent Haemodialysis Reliable Outflow graft insertion. Median age was 55 (20每86)ˋyears, 24 (46%) were male and 66% were Caucasian. Median follow-up was 290 (10每966)ˋdays and patient survival was 41/52 (79%). In total, 48 procedures were in the upper limb with 39 using the brachial artery as inflow (75%). The internal jugular vein and subclavian vein were most frequently used as access for outflow insertion. Primary patency rates at 6, 12, and 24ˋmonths were 51.2% (95% confidence interval, 38.8%每67.4%), 40.9% (95% confidence interval, 28.7%每58.2%), and 33.4% (95% confidence interval, 21.3%每52.5%), respectively. Secondary patency rates at 6, 12, and 24ˋmonths were 84.8% (95% confidence interval, 75%每95.9%), 76.5% (95% confidence interval, 64.5%每90.6%), and 70.6% (95% confidence interval, 56%每88.9%), respectively. There were 65 surgical and 49 radiological interventions resulting in 2.30 interventions per year to retain patency. Complications included four infections and two episodes of steal syndrome. The Haemodialysis Reliable Outflow graft provides acceptable 12-month secondary patency rates and acceptable complication rates in a UK and Ireland multi-centre series of complex access patients. Haemodialysis Reliable Outflow should be considered in patients with central pathology as a potential alternative to lower limb grafts and long-term central venous catheters
%K Vascular access
%K haemodialysis
%K arteriovenous graft
%K central venous occlusion
%K complex vascular access
%U https://journals.sagepub.com/doi/full/10.1177/1129729818770588