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The Scientific World Journal
Volume 2014, Article ID 318629, 4 pages
http://dx.doi.org/10.1155/2014/318629
Review Article

Modification of the HeRO Graft Allowing Earlier Cannulation and Reduction in Catheter Dependent Days in Patients with End Stage Renal Disease: A Single Center Retrospective Review

1General Surgery Department, University of Missouri-Kansas City School of Medicine, Kansas City, MO 64108, USA
2Saint Luke’s Hospital Transplant Specialists, Kansas City, MO 64111, USA
3Section of Interventional Radiology, UMKC-SOM, Saint Luke’s Hospital of Kansas City, 4401 Wornall Road, Kansas City, MO 64111, USA
4Saint Luke’s Hospital Interventional Radiology Department, Kansas City, MO 64111, USA

Received 17 September 2013; Accepted 5 December 2013; Published 6 January 2014

Academic Editors: R. Ando, F. Hinoshita, and R. Sakai

Copyright © 2014 Deirdre Hart et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

After creation of an arteriovenous fistula or placement of an arteriovenous graft, several weeks are required for maturation prior to first cannulation. Patients need an alternative way to receive hemodialysis during this time, frequently a catheter. After multiple failed access attempts, patients can run out of options and become catheter dependent. At our institution, we place HeRO grafts in eligible patients who have otherwise been told they would be catheter dependent for life. By combining the HeRO graft system with a Flixene graft, patients are able to remove catheters sooner or avoid placement as they can undergo cannulation for hemodialysis the next day. Utilizing this novel technique, twenty-one patients over a two-year period with various forms of central venous stenosis, catheter dependence, or failing existing arteriovenous access have been successfully converted to stable long term noncatheter based upper extremity access.