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FRUHWIRTH, J; KOCH, G; GUTSCHI, S; HAUSER, H; HORINA, J.
ALLOPLASTIC VASCULAR ACCESS IN HEMODIALYSIS
NIEREN HOCHDRUCK. 1995; 24(5): 270-273.
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Co-authors Med Uni Graz: Hauser Hubert
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Abstract:: A direct arteriovenous fistula provides the most durable access site for hemodialysis with excellent long-term patency and a low infection rate. Once the sites for a direct arteriovenous (av) fistula in the upper extremity have been exhausted, a prosthetic bridge graft is often required. initially in the upper arm. When this option is no longer feasible we often resort to an allograft loop in the forearm or the lower extremity. In total 182 PTFE-shunts (116 brachiosubclavian bridge graft fistulas. 45 loopgrafts in the lower extremity and 21 loop-grafts in the forearm) were created in 146 patients, constituting 15,7% of all av-fistulas created at the Department of Vascular Surgery Karl Franzens University Graz, Austria in a period of 6 years. The patency rate was calculated by means of the actuarial or life-table method, which accounts for differing lengths of follow-up in the grafts. The overall patency rates, including thrombectomy and revision were 77,5% in brachiosubclavian shunts, 69,4% in lower extremity loop-grafts and 65,1% in forearm loop-grafts after 24 months. The average number of revision and/or thrombectomy procedures performed for each upper arm bridge graft was 0.43, for loops in lower extremity 0.69 and for loops in the forearm 0,71. The types of operations performed to keep the grafts patient included: thrombectomy n = 44. repair of aneurysms n = 16, patch angioplasty n = 14, percutaneous intraluminal angioplasty n = 12. Evacuation of hematoma and infections treated with nonsurgical measures were not included. Removal of the graft because of deep infections were necessary in 9 cases. Distal ischemia in lower extremity required shunt ligation in 1 patient.
Find related publications in this database (Keywords): HEMODIALYSIS; VASCULAR GRAFT; ARTERIOVENOUS SHUNT