Early cannulation of bovine carotid artery grafts (Artegraft) after primary vascular access and fistula revision procedures

Autor: Steven G. Katz, Sherwin Abdoli, Sukgu M. Han, Christian Ochoa, Vincent L. Rowe, Anuj Mahajan
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Catheterization
Central Venous
Time Factors
medicine.medical_treatment
Fistula
Carotid arteries
030232 urology & nephrology
Vascular access
Arteriovenous fistula
030204 cardiovascular system & hematology
Prosthesis Design
Catheterization
Upper Extremity
03 medical and health sciences
Blood Vessel Prosthesis Implantation
0302 clinical medicine
Arteriovenous Shunt
Surgical
Renal Dialysis
Risk Factors
medicine
Animals
Humans
Dialysis
Vascular Patency
Aged
Retrospective Studies
Aged
80 and over
Bioprosthesis
business.industry
Incidence (epidemiology)
Graft Occlusion
Vascular
Dialysis catheter
Middle Aged
medicine.disease
Surgery
Blood Vessel Prosthesis
Carotid Arteries
Treatment Outcome
Heterografts
Cattle
Female
Cardiology and Cardiovascular Medicine
business
Complication
Zdroj: Journal of vascular surgery. 68(6)
ISSN: 1097-6809
Popis: Tunneled dialysis catheter (TDC) use has been associated with increased infectious complications and mortality in hemodialysis-dependent patients. Unfortunately, patients who undergo fistula revisions or creation of a new arteriovenous fistula frequently require a TDC during the postoperative period. Bovine carotid artery grafts (BCAGs) can be used as an early-access dialysis conduit to reduce TDC dependence. This study describes the performance of BCAGs that were cannulated early (3 days) after implantation and associated clinical outcomes.BCAGs were implanted in 63 consecutive dialysis-dependent patients. Patients and dialysis centers were directly provided early cannulation instructions; 31 (49%) patients were cannulated early, and of the 31 patients cannulated early, 21 (68%) were cannulated during the first postoperative day. Early complications, primary patency, secondary patency, and TDC incidence were monitored through clinic visits, hospital records, and phone calls to dialysis centers.The primary patency of BCAGs at 1 year in the early and late cannulation cohorts was 28% and 39%, respectively. The secondary patency of BCAGs at 1 year in the early and late cannulation cohorts was 74% and 77%, respectively. Early complications occurred in 11 (19%) patients who received a BCAG. There were no significant differences in complication rates between early and late cannulation patients. Of the 24 patients who underwent the operation without a pre-existing TDC, only three (13%) required TDC placement during the 30-day postoperative period.BCAGs can be cannulated early without increased complication rates or a negative impact on midterm patency. Early cannulation of BCAGs obviates the need for a TDC postoperatively in dialysis-dependent patients undergoing primary vascular access or fistula revision procedures.
Databáze: OpenAIRE
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