Antecubital jump revisions for salvaging hemodialysis grafts

When expanded polytetrafluoroethylene (PTFE) is used for hemodialysis acces s, the authors' initial preference is a forearm loop arteriovenous (AV) gra ft below the antecubital fossa, However, AV graft thrombosis remains a sign ificant problem caused mainly by venous outflow hyperplasia and managed oft en by either surgical or radiologic thrombectomy and angioplasty. At the ti me of surgical revision, the lack of an adequate superficial or deep forear m outflow vein below the elbow would require an antecubital (across the elb ow) jump bypass revision to a more proximal upper arm vein to salvage the o riginal forearm AV graft. With an increasing interest in monitoring the spe cific outcomes of the different surgical interventions used to salvage thro mbosed hemoaccess, the authors reviewed their most recent 24-month experien ce of 32 antecubital jump revisions using ring reinforced PTFE. The mean pr imary patency of these antecubital jump revisions was 8.2 months with 18 pr esently patent. AV grafts revisions using antecubital jump grafts confer ad ditional patency; they are another important method for salvaging thrombose d AV hemodialysis grafts.