{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T13:59:49Z","timestamp":1785333589939,"version":"3.55.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Arteriovenous (AV) grafts are frequently used for hemodialysis when an AV fistula is not feasible. Recent improvements in prosthetic materials have led to comparable performance of upper and lower extremity grafts. We aimed to evaluate the patency rate (the time from initial placement to failure or intervention) and complications of groin versus upper extremity AV grafts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      In this cross-sectional study, conducted from October 2018 to October 2020 at a tertiary referral center, patients with either a lower extremity (groin) or upper extremity AV graft were included and followed for at least 2 years. Graft adequacy was defined as the ability to deliver a blood flow \u2265350 mL\/min with two-needle cannulation in \u22655 dialysis sessions in 1 month. Outcomes included infection, ischemia, neuropathy, and thrombosis. Statistical tests (Chi-square for categorical variables and\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -test for continuous variables) were used, with\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05 considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 213 hemodialysis patients (mean age: 54.4 \u00b1 17.4 years, 68.5% of males), 183 had upper extremity AV grafts and 30 had groin AV grafts. No significant differences were observed between the two groups for patency duration (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.088) or rates of infection, ischemia, neuropathy, thrombosis, and graft adequacy (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this cohort, groin AV grafts had similar patency and complication profiles compared to those in the upper extremities. Groin placement can be a viable alternative when upper extremity access is not suitable. Further studies using standardized graft materials and longer follow-up intervals are recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jrms.jrms_243_24","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T13:02:19Z","timestamp":1785330139000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation and comparison of patency rate and complications of synthetic arteriovenous grafts in the groin and upper extremities among hemodialysis patients"],"prefix":"10.4103","volume":"31","author":[{"given":"Abbas","family":"Saroukhani","sequence":"first","affiliation":[{"name":"Department of Surgery, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Tohidi","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Javad","family":"Tarrahi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4]]},"reference":[{"key":"R1-20260729","doi-asserted-by":"crossref","first-page":"467","DOI":"10.5301\/jva.5000390","article-title":"The use of the early cannulation prosthetic graft (Acuseal\u2122) for angioaccess for haemodialysis","volume":"16","author":"Maytham","year":"2015","journal-title":"J Vasc Access"},{"key":"R2-20260729","doi-asserted-by":"crossref","first-page":"493","DOI":"10.5301\/jva.5000412","article-title":"Early cannulation grafts for haemodialysis: A systematic review","volume":"16","author":"Al Shakarchi","year":"2015","journal-title":"J Vasc Access"},{"key":"R3-20260729","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.ejvs.2009.06.003","article-title":"Lower-extremity arteriovenous access for haemodialysis: A systematic review","volume":"38","author":"Antoniou","year":"2009","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"R4-20260729","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/sdi.12088","article-title":"Hand ischemia associated with dialysis vascular access: An individualized access flow-based approach to therapy","volume":"26","author":"Beathard","year":"2013","journal-title":"Semin Dial"},{"key":"R5-20260729","doi-asserted-by":"crossref","first-page":"259","DOI":"10.5301\/jva.5000323","article-title":"Preferred haemodialysis vascular access for diabetic chronic kidney disease patients: A systematic literature review","volume":"16","author":"Coentr\u00e3o","year":"2015","journal-title":"J Vasc Access"},{"key":"R6-20260729","doi-asserted-by":"crossref","first-page":"180","DOI":"10.5758\/vsi.2016.32.4.180","article-title":"Long term outcomes of arteriovenous grafts for hemodialysis in lower extremities","volume":"32","author":"Han","year":"2016","journal-title":"Vasc Specialist Int"},{"key":"R7-20260729","doi-asserted-by":"crossref","first-page":"2942","DOI":"10.1097\/01.ASN.0000090746.88608.94","article-title":"Comparison of arteriovenous grafts in the thigh and upper extremities in hemodialysis patients","volume":"14","author":"Miller","year":"2003","journal-title":"J Am Soc Nephrol"},{"key":"R8-20260729","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1111\/sdi.12501","article-title":"We underutilize the leg graft","volume":"29","author":"Allon","year":"2016","journal-title":"Semin Dial"},{"key":"R9-20260729","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1007\/s00467-020-04821-y","article-title":"Evolution and change in paradigm of hemodialysis in children: A systematic review","volume":"36","author":"Chanchlani","year":"2021","journal-title":"Pediatr Nephrol"},{"key":"R10-20260729","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1007\/s11908-011-0192-x","article-title":"Vascular access infections: Epidemiology, diagnosis, and management","volume":"13","author":"Akoh","year":"2011","journal-title":"Curr Infect Dis Rep"},{"key":"R11-20260729","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1177\/1358863X15612574","article-title":"Management of infected vascular grafts","volume":"21","author":"Kilic","year":"2016","journal-title":"Vasc Med"},{"key":"R13-20260729","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1586\/erc.12.33","article-title":"Therapeutic strategies to combat neointimal hyperplasia in vascular grafts","volume":"10","author":"Collins","year":"2012","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"R14-20260729","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1177\/2054358116669127","article-title":"Arteriovenous access: Infection, neuropathy, and other complications","volume":"3","author":"MacRae","year":"2016","journal-title":"Can J Kidney Health Dis"},{"key":"R16-20260729","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1089\/sur.2011.041","article-title":"Infected prosthetic dialysis arteriovenous grafts: A single dialysis center study","volume":"13","author":"Bachleda","year":"2012","journal-title":"Surg Infect (Larchmt)"},{"key":"R17-20260729","doi-asserted-by":"crossref","first-page":"245","DOI":"10.3109\/03009731003678562","article-title":"Patency rate and complications of polytetrafluoroethylene grafts compared with polyurethane grafts for hemodialysis access","volume":"115","author":"Ravari","year":"2010","journal-title":"Ups J Med Sci"},{"key":"R18-20260729","doi-asserted-by":"crossref","first-page":"e000776","DOI":"10.1136\/tsaco-2021-000776","article-title":"Risk factors for severe lower extremity ischemia following venoarterial extracorporeal membrane oxygenation: An analysis using a nationwide inpatient database","volume":"7","author":"Honda","year":"2022","journal-title":"Trauma Surg Acute Care Open"},{"key":"R20-20260729","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s12882-023-03086-5","article-title":"Study protocol of a randomized controlled trial of fistula versus graft arteriovenous vascular access in older adults with end-stage kidney disease on hemodialysis: The AV access trial","volume":"24","author":"Murea","year":"2023","journal-title":"BMC Nephrol"},{"key":"R21-20260729","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1186\/s13063-023-07513-8","article-title":"Impact of simulation-based training in addition to theoretical training versus theoretical training of nurses alone in the occurrence of adverse events related to arteriovenous fistula puncture in chronic hemodialysis patients: study for a cluster randomized controlled trial (SIMFAV2)","volume":"24","author":"Guillouet","year":"2023","journal-title":"Trials"},{"key":"R22-20260729","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1177\/11297298211027470","article-title":"Long-term outcomes following thrombolysis of arteriovenous grafts","volume":"25","author":"Li","year":"2024","journal-title":"J Vasc Access"},{"key":"R23-20260729","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.avsg.2023.06.016","article-title":"Comparison of lower and upper extremity arteriovenous graft: A retrospective clinical analysis with 5-year Follow-Up","volume":"98","author":"Zhang","year":"2024","journal-title":"Ann Vasc Surg"},{"key":"R24-20260729","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1681\/ASN.2012060632","article-title":"Fistula first is not always the best strategy for the elderly","volume":"24","author":"DeSilva","year":"2013","journal-title":"J Am Soc Nephrol"},{"key":"R25-20260729","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1038\/s41581-020-0333-2","article-title":"Challenges and novel therapies for vascular access in haemodialysis","volume":"16","author":"Lawson","year":"2020","journal-title":"Nat Rev Nephrol"},{"key":"R26-20260729","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s40814-020-00619-9","article-title":"A randomized pilot study to evaluate graft versus fistula vascular access strategy in older patients with advanced kidney disease: Results of a feasibility study","volume":"6","author":"Murea","year":"2020","journal-title":"Pilot Feasibility Stud"}],"container-title":["Journal of Research in Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jrms.jrms_243_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T13:02:23Z","timestamp":1785330143000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jrms.jrms_243_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jrms.jrms_243_24","relation":{},"ISSN":["1735-1995","1735-7136"],"issn-type":[{"value":"1735-1995","type":"print"},{"value":"1735-7136","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2024-05-10","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-18","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}