Abstract:

Objective To develop a chained management protocol for arteriovenous graft（AVG） and explore its effects in clinical practice. Methods An AVG chained management protocol was constructed through literature review and expert consultation. End-stage renal disease patients who had underwent AVG angioplasty in a hospital from January 1，2021，to December 31，2022，were recruited as study participants. Based on their willingness to receive AVG chained management，patients were divided into an experimental group or a control group. The experimental group received an AVG chained management protocol，while the control group received routine care. The primary and secondary patency times within one year after AVG cannulation，the clinic follow-up rate within one year after entering the access follow-up period，and the multi-single puncture execution rate within one year after AVG cannulation were collected and compared between the two groups. Results A total of 204 eligible patients were included，with 123 in the experimental group and 81 in the control group. The median primary patency time within one year after AVG cannulation was 12.0（8.6，12.0） months in the experimental group and 10.0 （6.8，10.0） months in the control group（χ²=5.870，P=0.015）. The median secondary patency time was 12.0 （9.2，12.0） months and 12.0（8.4，12.0） months in experimental group and control group，respectively（χ²=8.343，P=0.004）. The clinic follow-up rate within one year after entering the access follow-up period and the multi-single puncture execution rate within one year after AVG cannulation were higher in the experimental group than that in the control group（P<0.05）. Conclusion The implementation of the AVG chained management protocol is beneficial for prolonging AVG patency time in end-stage renal disease patients，improving patient adherence to clinic follow-up，and increasing the multi-single puncture execution rate.

Key words: Chain management, Arteriovenous graft, Follow-up compliance, Patency