Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2010, Vol. 32 ›› Issue (3): 324-327.doi: 10.3881/j.issn.1000-503X.2010.03.018

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Effectiveness of Polytetrafluoroethylene Graft for Hemodialysis Access and Treatment of Graft Occlusion

WU Wei-wei1,LIU Chang-wei1,LIU Bao1,YE Wei1,CHEN Yu1,JIANG Tao2   

  1. 1Department of Vascular Surgery,PUMC Hospital,CAMS and PUMC,Beijing 100032,China;2Department of General Surgery,Qingzhou People’s Hospital,Qing zhou,Shandong 262500,China
  • Received:2009-10-13 Online:2010-06-30 Published:2010-09-10
  • Contact: LIU Chang-wei Tel: 010-88068230,E-mail:liucw@vip.sina.com E-mail:liucw@vip.sina.com

Abstract: Objective To assess the patency and complications of the polytetrafluoroethylene (PTFE) graft for hemodialysis access and to summarize the experiences in the treatment of graft occlusions. Methods The clinical data of 30 patients who underwent forearm PTFE graft for hemodialysis access from March 2003 to December 2008 in our hospital were retrospectively analyzed. Results Patients were followed up for (28.7±17.6) months (range: 8-78 months).The peri-operative mortality was zero. Primary patency rate was 70.0% at Year 1 and 56.7% at Year 2. Accumulative secondary patency rate was 90.0% and 80.0%,respectively at Year 1 and Year 2. Postoperative complications included graft thrombosis (n=13,43.3%),venous anastomosis stenosis (n=1,3.3%),graft infection (n=2,6.7%),and edema of the forearm (n=10,33.3%). Totally 24 graft revisions were performed,including thrombectomy (12 times),thrombectomy and venous anastomosis plasty with artificial patch (4 times),arterial and venous anastomosis plasty with patch (2 times),venous anastomosis angioplasty with a balloon (2 times),new graft hemodialysis access construction in the contralateral arm (1 case),and graft removal (3 cases). Conclusions PTFE graft is an important backup hemodialysis access in urinemic patients. Proper revision according to different cause of graft occlusions can prolong the service time of the graft.

Key words: artificial graft, hemodialysis, arterio-venous fistula

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