[Use of a thin wall Impra prosthesis for a vascular approach in chronic hemodialysis. Short- and middle-term evaluation. Apropos of 66 cases].
The authors report their experience of thin wall PTFE IMPRA prostheses in providing vascular access for chronic haemodialysis. Sixty-six prostheses were inserted between 14/10/1983 and 31/10/1986, with review of all patients at 31/6/1987. Twenty-three per cent of patients died during the study period. Patency analysed by the actuarial method was 49.07 +/- 15.7% at 2 years. There was no evidence of any significant difference between use of the forearm and of the arm. The main cause of failure was early (responsible for the loss of 9.2% of prostheses) or secondary (after the first month) thrombosis. A total of 30.3% of prostheses were lost by thrombosis by the end of 2 years, the principal cause being anastomotic or post-anastomotic venous stenosis. The use of thin walls in no way modified the incidence of this complication. The authors suggest its preventive protection by routine ansography. False aneurysms occurred beyond 18 months of dialysis requiring removal of the prosthesis in 3 cases. Thinning of the wall is one of the probable factors involved in this complications, justifying the abandonment of this type of prosthesis in this indication despite technical advantages at implantation and during use.
Baste
J C
JC
Service de Chirurgie Générale et Vasculaire, Hôpital St André, Bordeaux.
Midy
D
D
Albert
M
M
Panes
F
F
Ragnaud
J M
JM
Wone
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis; D002908:Chronic Disease; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D006435:Renal Dialysis / Q000295:instrumentation*; D014654:Vascular Patency
D011138:Polytetrafluoroethylene
L'utilisation des prothèses Impra à paroi fine dans l'abord vasculaire en hémodialyse chronique. Evaluation à court et à moyen terme. A propos de 66 observations.