HeRO graft versus lower extremity grafts in hemodialysis patients with long standing renal failure.

Background: The role of the HeRO graft in central venous pathology has been defined in the literature and clinically. There have been two publications or abstracts that have compared the patency rates and outcomes of this graft to the lower extremity graft.

Aim: The outcomes of both publications leads to an algorithm suggested by the author in determining which procedure should be used for specific patients.

Methods: Both papers trend to show that lower extremity grafts have improved patency rates when compared to the HeRO device in the upper extremity.

Discussion: The author will use these data to demonstrate that in younger patients and in patients with low morbidity and mortality, salvaging the upper extremity area for access may show that the HeRO device provides benefit for these patients.