Thrombosed AV grafts

Arteriovenous (AV) access grafts that have thrombosed are often associated with worse outcomes than those that are stenosed1

  • The 2019 KDOQI guidelines for vascular access specify a target goal of ≤ three interventions annually to maintain access2:

    • In support of achieving this goal, KDOQI recommends stent grafts in preference to angioplasty alone for recurrent thrombotic AV access lesions

There are a limited number of randomized trials to help guide evidence-based treatment decisions for patients with thrombosed grafts

  • In the Gore REVISE Clinical Study, 43% of patients in the GORE® VIABAHN® Endoprosthesis with PROPATEN Bioactive Surface*,† arm of the study enrolled with a thrombosed graft1 
angiogram

Before

Treatment of stenosis at the venous anastomosis of a synthetic graft

Images courtesy of Thomas Ward, M.D. Used with permission.

Read the full case study

angiogram

After

Post-placement of 8 mm x 7.5 cm GORE® VIABAHN® Endoprosthesis

Images courtesy of Thomas Ward, M.D. Used with permission.

Read the full case study

The GORE® VIABAHN® Endoprosthesis has proven success when treating thrombosed grafts1, 2 

Proven patency

  • Exceeded KDOQI minimum guidelines for three-month circuit primary patency for thrombotic patients (48%) whereas percutaneous transluminal angioplasty (PTA) did not (39%)1,2
  • Increased primary patency in thrombosed grafts of both the target lesion and the circuit by ~50% when compared to PTA at six months1

Fewer reinterventions

  • Lowered the mean number of interventions over two years by 40% in thrombosed grafts3

* As used by Gore, PROPATEN Bioactive Surface refers to Gore’s proprietary CBAS Heparin Surface.

† Also referred to as the GORE® VIABAHN® Endoprosthesis with Heparin Bioactive Surface in some regions.

  1. Vesely T, DaVanzo W, Behrend T, Dwyer A, Aruny J. Balloon angioplasty versus Viabahn stent graft for treatment of failing or thrombosed prosthetic hemodialysis grafts. Journal of Vascular Surgery 2016;64(5):1400-1410.e1. http://www.sciencedirect.com/science/article/pii/S0741521416301756
  2. Lok CE, Huber TS, Lee T, et al; KDOQI Vascular Access Guideline Work Group. KDOQI Clinical Practice Guideline for Vascular Access: 2019 update. American Journal of Kidney Diseases 2020;75(4)Supplement 2:S1-S164.
  3. Mohr BA, Sheen AL, Roy-Chaudhury P, Schultz SR, Aruny JE; REVISE Investigators.  Clinical and economic benefits of stent grafts in dysfunctional and thrombosed hemodialysis access graft circuits in the REVISE Randomized Trial.  Journal of Vascular & Interventional Radiology 2019;30(2):203-211.e4.

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