Intravenous transcutaneous vascular access device.
The indwelling transcutaneous vascular access device is easily implantable with little more skill or time required than is typically used in placement of standard intravenous needles or catheters. With routine maintenance of the device site, the infection rate in our studies are negligible. Biocompatibilty, assessed by the lack of destruction of blood components and by the paucity of signs of initimal or systemic disease, was good. Over the period of 10 to 21 days, all but one unit maintained adequate flow rates. The device is stable. There was no blood leakage from the area around the limbs in the chronic flow studies or the hemodialysis studies. The one episode of malpositioning occurred after a sudden strong tug on the tubing. A second dacron retaining cuff will be placed on the distal limb. This will be sutured into place and should increase unit stability. There was little evidence of pain or irritation from the device. No thrombotic tendencies were noted at the access site or systemically. The dogs were on Ascriptin and also the model (canine) is not prone to thromboembolic events. Further improvements on the device will include using smoother, more compatible materials: carbon-coated steel, brushed titanium, or covering the steel with PTFE or ceramic rather than the silastic-dacron cuff. Other future changes include the improvement of the device-tubing connection to one in which no blood will be lost when the device is attached to the dialyzer.(ABSTRACT TRUNCATED AT 400 WORDS)
D000818:Animals; D001166:Arteriovenous Shunt, Surgical; D001807:Blood Vessel Prosthesis; D004285:Dogs; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D006435:Renal Dialysis; D012212:Rheology