Department of Surgery, Division of Vascular Surgery, Johns Hopkins Bayview Medical Center Baltimore, Maryland
Summary: We advocate for arteriovenous (AV) access removal in patients with stable renal transplants to mitigate the significant cardiopulmonary and limb complications associated with chronic high-flow physiology. Repairing the inflow artery after AV access excision is difficult because proximal dilation, distal atrophy, and arteriotomy lengthening make longitudinal closure prone to narrowing, while vein patch or cuff techniques preserve diameter but risk aneurysmal degeneration. This study demonstrates that a simple transverse closure preserves the native artery for future access and offers a safe, durable repair with excellent early outcomes.
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