The role of intraoperative angiography in salvaging bovine grafts for hemodialysis.
Bovine grafts used in hemodialysis frequently need declotting. Success of the declotting procedure usually is dependent upon relieving outflow obstruction. Intraoperative angiography was done during 22 declotting procedures and outflow obstructions were detected in 14 grafts. Of these 5 grafts had clinically unsuspected clots, residual to the initial declotting attempt. Four grafts had stenotic areas at the site of the venous anastomosis, which were corrected subsequently by patch grafts. Two grafts had stenotic areas in the graft owing to an infolding of the intima covered with an organized blood clot. In 2 grafts the veins draining the grafts were stenotic for a considerable length and needed revision. In 1 graft there was stenotic change at the site of the arterial anastomosis, which required revision. Of the 14 grafts 11 have remained functioning for an additional 6 to 18 months after relief of obstruction.
D000328:Adult; D000818:Animals; D001166:Arteriovenous Shunt, Surgical; D001705:Bioprosthesis; D002417:Cattle; D003251:Constriction, Pathologic; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D011859:Radiography; D006435:Renal Dialysis; D013923:Thromboembolism / Q000000981:diagnostic imaging* / Q000209:etiology