Use of expanded polytetrafluoroethylene grafts for vascular access in hemodialysis: laboratory and clinical evaluation

Vascular access for chronic hemodialysis has evolved considerably over the past 10 years with development of vascular substitutes. The bovine heterograft is the choice of most dialysis centers when a subcutaneous conduit is needed in lieu of an in situ arteriovenous fistula. Bovine grafts have solve...

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Bibliographic Details
Published inThe American surgeon Vol. 43; no. 7; p. 455
Main Authors Elliott, M P, Gazzaniga, A B, Thomas, J M, Haiduc, N J, Rosen, S M
Format Journal Article
LanguageEnglish
Published United States 01.07.1977
Subjects
Adolescent
Adult
Animals
Arteriovenous Shunt, Surgical - instrumentation
Arteriovenous Shunt, Surgical - methods
Blood Vessel Prosthesis - instrumentation
Child
Dogs
Femoral Artery - surgery
Femoral Vein - surgery
Graft Survival
Humans
Kidney Failure, Chronic - therapy
Middle Aged
Polytetrafluoroethylene
Postoperative Complications
Renal Dialysis
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Summary:Vascular access for chronic hemodialysis has evolved considerably over the past 10 years with development of vascular substitutes. The bovine heterograft is the choice of most dialysis centers when a subcutaneous conduit is needed in lieu of an in situ arteriovenous fistula. Bovine grafts have solved some problems, but further improvement in blood access prostheses is needed. Polytetrafluoroethylene (PTFE) grafts were evaluated in a laboratory and clinical study. In animals, PTFE proved to be satisfactory for fistula construction based on patency, incorporation into tissue, and ease of puncture. Ten patients underwent 11 vascular access procedures using PTFE grafts as a conduit. There were no technical operative complications. One graft was occluded by extravasation during dialysis and flow could not be restored. Otherwise, all grafts are patent 9 to 18 months postoperatively. Grafts of 8.0 mm in diameter have not given desirable flow rates, whereas 6.0 mm grafts have. Prolonged bleeding from puncture has been a problem in some cases. Otherwise, PTFE appears to be a satisfactory conduit for hemodialysis vascular access.
ISSN:0003-1348