Τίτλος:
Safety and efficacy of polyurethane vascular grafts for early hemodialysis access
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background Arteriovenous grafts made of polyurethane (PU) have the advantage of early cannulation obviating the placement of a central vein catheter in patients with an acute need for long-term hemodialysis. The aim of the present study was to evaluate the safety, efficacy and complication rate of PU vascular grafts for dialysis access in patients in whom early cannulation was performed. Methods Between January 2007 and December 2015, 125 straight brachial-axillary grafts were placed in patients with an acute thrombosis of a previous arteriovenous access. Sixty-four were PU and 61 were polytetrafluoroethylene (PTFE) grafts. Patency and complications rates were compared between the two groups. Results The median interval from implantation to cannulation was 1 day in the PU group vs 28 days in the PTFE group. Cumulative infection rate at 5 years was 13% and 8% in the PU and the PTFE groups, respectively (P =.6). None of the patients in the PU group developed a pseudoaneurysm necessitating intervention, compared with one patient in the PTFE group. Primary and secondary patency rates did not differ significantly between the two groups. The cumulative median primary patency was 23 months in the PU group vs 26 months in the PTFE group. Median secondary patency was 42 vs 33 months, respectively. Diabetes mellitus was the only factor adversely affecting graft patency in both groups. Conclusions PU grafts offer the advantage of early cannulation with infection, pseudoaneurysm formation and patency rates similar to those of the PTFE grafts. © 2017 Society for Vascular Surgery
Συγγραφείς:
Kakisis, J.D.
Antonopoulos, C.
Mantas, G.
Alexiou, E.
Katseni, K.
Sfyroeras, G.
Moulakakis, K.
Geroulakos, G.
Περιοδικό:
Journal of Vascular Surgery
Εκδότης:
Mosby Year Book Inc
Λέξεις-κλειδιά:
glucose; insulin; politef; polyurethan; vancomycin; polyurethan, aged; antibiotic prophylaxis; Article; axillary vein; blood vessel graft; cerebrovascular accident; cohort analysis; color Doppler flowmetry; comparative study; congestive heart failure; controlled study; diet restriction; false aneurysm; female; follow up; glucose blood level; graft infection; graft patency; heart infarction; hemodialysis; human; infection rate; lung embolism; lung infection; major clinical study; male; malignant neoplasm; patient safety; percutaneous transluminal angioplasty; priority journal; recurrent disease; retrospective study; thrombosis; treatment outcome; vascular access; vascular patency; vein anastomosis; arteriovenous shunt; blood vessel prosthesis; blood vessel transplantation; catheterization; chemistry; devices; diagnostic imaging; graft occlusion; Kaplan Meier method; middle aged; pathophysiology; prosthesis design; risk factor; thrombosis; time factor, Aged; Arteriovenous Shunt, Surgical; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Catheterization; Female; Graft Occlusion, Vascular; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Polytetrafluoroethylene; Polyurethanes; Prosthesis Design; Renal Dialysis; Retrospective Studies; Risk Factors; Thrombosis; Time Factors; Treatment Outcome; Vascular Patency
DOI:
10.1016/j.jvs.2017.06.083
