Description and early outcomes of the hybrid graft for dialysis.

INTRODUCTION: Long-term dialysis access has become more challenging as patient survival has improved in end-stage renal disease. The GORE® Hybrid Vascular Graft (GHVG) has been designed to improve dialysis access outcomes and provide additional access options for challenging patients. In this article, we will review the design of the graft, unique properties and reported outcomes.

METHODS: We reviewed data available at our institution and performed a Pubmed search on GORE® Hybrid Vascular graft. We found two more studies besides the data published by our department.

RESULTS: To date, there have been three papers showing early results of these grafts. All studies report successful placement of the grafts with no unexpected complications. Limb edema has not been a common problem, despite concerns of placing a stent graft into the axillary vein. The papers have shown 70% cumulative patency of the GHVG at 12 months. The comparative studies showed no significant benefit compared to conventional grafts. We see this as an option of continuing with arm access rather than going to more complex access creation such as a chest wall access or going to access creation in the legs.

CONCLUSIONS: The GHVG has been shown to have comparable performance to standard arteriovenous graft techniques and can expand access options for some patients with challenging anatomy.