Early Experience with a Newly Developed Electrospun Polycarbonate-urethane Vascular Graft for Hemodialysis Access
| Autor: | Paolo Nobili, Mariano Ferraresso, Ettore Maria Bortolani, Silvio Bertoli |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Time Factors medicine.medical_treatment Treatment outcome Pilot Projects Kaplan-Meier Estimate Prosthesis Design Urethane Upper Extremity Blood Vessel Prosthesis Implantation Arteriovenous Shunt Surgical Renal Dialysis Blood vessel prosthesis Humans Prosthesis design Medicine Prospective Studies Vascular Patency Hemodialysis access Aged Thrombectomy Polycarboxylate Cement business.industry Graft Occlusion Vascular Thrombosis Middle Aged Blood Vessel Prosthesis Surgery Treatment Outcome Thigh Nephrology Polycarbonate urethane Female Hemodialysis business Vascular graft |
| Zdroj: | The Journal of Vascular Access. 14:252-256 |
| ISSN: | 1724-6032 1129-7298 |
| DOI: | 10.5301/jva.5000128 |
| Popis: | Purpose In this pilot study, we tested a newly developed electrospun multilayered, self-sealing graft, AVflo™, specifically designed for early hemodialysis access. Methods Ten eligible consenting patients had a polycarbonate-urethane graft (AVflo™) implanted and were followed up prospectively for at least six months. Performance measures included graft patency, complications and time to first cannulation. Mean age of the patients was 66.7 ± 10 years. Chronic glomerulonephritis was the most common cause of renal failure. A total of 70% of the patients had a history of previous vascular access and 40% history of minimally invasive radiologic procedures for patency maintenance. In 40% of the cases the need for AV graft implantation was because of recurrent infections from permanent catheter for dialysis. Seven grafts were placed in the upper arm and three in the thigh. Mean follow up was 230 ± 75 days. Results There were no systemic or local reactions to the graft and we did not report any graft infections. Two grafts thrombosed because of severe bleeding post-cannulation due to an incorrect needle puncture. Both grafts were successfully thrombectomized. Primary and secondary patency rates at six months were 60% and 78%, respectively. These patency rates were comparable to those reported for other polyether-urethane and ePTFE grafts. Median time to first cannulation was seven days (3-21) and all puncture sites sealed in less than five minutes. Conclusions This newly developed electrospun polycarbonate-urethane graft is safe in humans, permits early access obviating the need for venous catheters, and has equivalent patency as other prosthetic grafts. |
| Databáze: | OpenAIRE |
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