Salvage operations for malfunctioning polytetrafluoroethylene hemodialysis access grafts

During the study period a cohort of 170 of patients receiving long-term hemodialysis treatment required placement of 214 polytetrafluoroethylene grafts for vascular access; within this period 74 of these patients had significant graft malfunction that required 149 salvage operations. The most common...

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Bibliographic Details
Published inSurgery Vol. 94; no. 3; p. 464
Main Authors Etheredge, E E, Haid, S D, Maeser, M N, Sicard, G A, Anderson, C B
Format Journal Article
LanguageEnglish
Published United States 01.09.1983
Subjects
Adolescent
Adult
Aged
Arteriovenous Shunt, Surgical - instrumentation
Blood Vessel Prosthesis
Child
Child, Preschool
Female
Follow-Up Studies
Forearm - blood supply
Humans
Kidney Failure, Chronic - therapy
Male
Middle Aged
Polytetrafluoroethylene
Renal Dialysis - methods
Thigh - blood supply
Thrombosis - etiology
Thrombosis - surgery
Time Factors
Veins - pathology
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Summary:During the study period a cohort of 170 of patients receiving long-term hemodialysis treatment required placement of 214 polytetrafluoroethylene grafts for vascular access; within this period 74 of these patients had significant graft malfunction that required 149 salvage operations. The most common failure/malfunction was thrombosis, and the most commonly appreciated mechanical cause of graft failure was outflow venous stenosis. Complex revisions were required to address this problem. First, second, and third revisions were successful in 65%, 53%, and 44% of cases, respectively. Multiple revisions, including thrombectomy, were required in some, but the functional life of these salvaged grafts was nearly equal to that of grafts that did not require revision. Abandonment of grafts because of secondary infection exacted a toll in both groups.
ISSN:0039-6060