Stent graft effective irrespective of length of VAIVT interval

Future considerations regarding arteriovenous graft placement

Abstract

We conducted a study to determine the optimal timing for treating arteriovenous graft (AVG) outflow tract stenosis by comparing intervention intervals pre and post stent graft implantation. This study included cases of stent graft implantation for upper limb AVG outflow tract stenosis in our department from August 2020 to December 2022. We compared the mean number of days between the three VAIVT sessions before stent graft implantation (Pre-SG) and the first VAIVT session after stent graft implantation (Post-SG). The median Pre-SG in all 31 patients was 98 days (interquartile range： 61 to 146 days) and the median Post-SG was 403 days (195 to 539 days), which represents a significant fourfold increase in VAIVT intervals (p＜0.05). However, in three cases, Post-SG was shorter than Pre-SG. To ensure long-term patency after stent graft implantation, it is important to select a large-diameter, more central vein with a high patency rate as the site of AVG placement from the beginning, to ensure complete coverage of the target lesions, and use the elephant trunk technique.