A systematic review of right atrial bypass grafting in the management of central venous occlusive disease in patients undergoing hemodialysis

INTRODUCTION: Central venous occlusive disease (CVOD) is a complication that can occur in patients with end-stage renal disease who are receiving hemodialysis. When CVOD develops, patients often require multiple re-interventions to maintain their dialysis access. CVOD can be treated by various strategies such as balloon angioplasty, stenting, lower limb or extra-anatomical grafts, hybrid grafts or surgical bypasses such as right atrial (RA). In this systematic review, we aim to evaluate the indications, technical aspects, and outcomes after RA bypass grafting for the treatment of CVOD in hemodialysis patients.

METHODS: A systematic and comprehensive literature search was conducted using various electronic databases. We included articles that reported described and reported outcomes of RA bypass grafting for the treatment of CVOD in hemodialysis patients. A narrative review of the indications and technical aspects of RA bypass grafting was performed. We also pooled and reported the primary patency, secondary patency, postoperative complications, and 30-day mortality of RA bypass grafting.

RESULTS: A total of 21 studies with 55 patients who underwent RA bypass grafting were included in our systematic review. Follow-up period ranged from 0.5 to 84 months. The mean pooled primary patency and secondary patency of RA bypass grafting were 8.1 ± 4.9 and 21.7 ± 20.1 months, respectively. The incidence of early postoperative complications such as surgical site infection, bleeding, and access thrombosis was 0%, 4%, and 4%, respectively. The overall 30-day mortality was 4%.

CONCLUSIONS: This systematic review summarizes the patient characteristics, technical features and outcomes of RA bypass grafting in the treatment of hemodialysis-related CVOD. RA bypass grafting may be a viable last-resort option when less invasive or conventional treatment options have been exhausted.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:25

Enthalten in:

The journal of vascular access - 25(2024), 1 vom: 19. Jan., Seite 14-26

Sprache:

Englisch

Beteiligte Personen:

Paik, Benjamin [VerfasserIn]
Tee, Zi Heng [VerfasserIn]
Masuda, Yoshio [VerfasserIn]
Choong, Andrew Mtl [VerfasserIn]
Ng, Jun Jie [VerfasserIn]

Links:

Volltext

Themen:

Central bypass graft
Central venous occlusive disease
Dialysis
Dialysis access
End-stage renal disease
Journal Article
Prosthetic grafts
Review
Systematic Review

Anmerkungen:

Date Completed 06.02.2024

Date Revised 06.02.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1177/11297298221095320

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM340602201