Abstract: 【Abstract】Objectives To discuss the early perioperative prevention and treatment of arteriovenous graft (AVG) induced ischemia. Methods The effect of perioperative prevention and treatment of AVG induced ischemia in Department of Vascular Surgery, Shanghai Longhua Hospital was retrospectively analyzed. Results From Jan. 2017 to Apr. 2018, upper limb AVG was performed in a total of 129 cases. Light or moderate hand ischemia was found in 87 cases, with the mean age of 58.9±11.2 yrs and mean dialysis period of 76.3±64.5 months; 59 cases (67.8%) had gradeⅠischemia, and 28 cases (32.2%, 27 cases with numb and one case with ache) had grade Ⅱa ischemia. Capillary filling time immediately after the operation was significantly longer than that of preoperation (3.69±0.45s vs. 1.58±0.14s, P＜0.001). After treatment of warm preservation, alprostadil and papaverine for spasmolysis and vascular dilatation, the symptoms of ischemia relieved. Capillary filling time after operation for 5 days and that of preoperation became no statistically different anymore (P=0.172). The comparison between capillary filling time before operation, immediately after operation and after operation for 5 days by one-way ANOVA showed a result of F=1588.274, P＜0.001. Conclusions Comprehensive evaluation and carefully designing the operation before AVG and warm preservation and drugs for spasmolysis and vascular dilatation after AVG operation can effectively prevent and reduce the postoperative ischemia.

Key words: Hemodialysis, Arteriovenous graft, Ischemia