Early infection risk with primary versus staged Hemodialysis Reliable Outflow (HeRO) graft implantation Andrew S. Griffin, MD, Shawn M. Gage, PA-C, Jeffrey.

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Presentation transcript:

Early infection risk with primary versus staged Hemodialysis Reliable Outflow (HeRO) graft implantation Andrew S. Griffin, MD, Shawn M. Gage, PA-C, Jeffrey H. Lawson, MD, PhD, Charles Y. Kim, MD Journal of Vascular Surgery Volume 65, Issue 1, Pages 136-141 (January 2017) DOI: 10.1016/j.jvs.2016.07.114 Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig Example of an intentionally staged Hemodialysis Reliable Outflow (HeRO; Merit Medical, South Jordan, Utah) insertion in a 67-year-old man with a history of multiple prior bilateral extremity permanent accesses and endovascular procedures. A, A contrast-enhanced magnetic resonance angiography maximal projection image demonstrates extensive occlusion of all of the central veins of the chest. B, A digitally subtracted venogram from the right internal jugular vein demonstrates chronic occlusion of the central veins, including a superior vena cava- to-left brachiocephalic vein stent. C, After recanalization to the right atrium, a tunneled central venous catheter is inserted across the extensive venous occlusions as a placeholder for guidewire access during HeRO graft insertion. D, A chest radiograph demonstrates a successfully inserted HeRO device with the tip in the right atrium performed 3 weeks after recanalization. Journal of Vascular Surgery 2017 65, 136-141DOI: (10.1016/j.jvs.2016.07.114) Copyright © 2016 Society for Vascular Surgery Terms and Conditions