title: Hemodialysis graft infections treated with cryopreserved femoral vein.
abstract: Introduction. Treatment of infected hemodialysis grafts is associated with prolonged hospitalization and wound care. The use of cryopreserved femoral vein (CFV) for angioaccess in infected hemodialysis grafts was prospectively evaluated.Methods. Forty-three CFV arteriovenous grafts (AVGs) were placed in 43 patients with prosthetic AVG infections. Thirty-two of the CFV AVGs were constructed adjacent to the infected AVG using a parallel tunnel tract, while 11 were placed into the infected field. All patients were prospectively followed at three-month intervals for graft complications and recurrent infections.Results. With a mean follow-up of 418 days, there was one recurrent infection (2.3%). The one-year primary and secondary graft patency rates were 42% and 68%, respectively. The two-year primary and secondary patency rates were 31% and 63%, respectively.Conclusions. Cryopreserved femoral vein proved useful in the treatment of infected hemodialysis grafts. The absence of infection after implantation around an infected area shows promise for salvaging an angioaccess site that would otherwise have been abandoned.
authors.affiliation: Department of Surgery, The Atlanta Medical Center, Suite 412, 315 Boulevard NE, Atlanta, GA 30312, USA. john-matsuura@hotmail.com
authors.forename: John H
authors.initials: JH
authors.lastname: Matsuura
authors.forename: David
authors.initials: D
authors.lastname: Rosenthal
authors.forename: Eric D
authors.initials: ED
authors.lastname: Wellons
authors.forename: Clare S
authors.initials: CS
authors.lastname: Castronovo
authors.forename: David
authors.initials: D
authors.lastname: Fronk
mesh_terms: D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D015925:Cryopreservation; D005260:Female; D005268:Femoral Vein / Q000637:transplantation*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000601:surgery*; D006435:Renal Dialysis; D016019:Survival Analysis; D016896:Treatment Outcome; D014654:Vascular Patency