Impact of cuffed, expanded polytetrafluoroethylene dialysis grafts on graft outlet stenosis.
BACKGROUND
The objective of this study was to determine prospectively the difference between the graft outlet strictures of a polytetrafluoroethylene (ePTFE) graft with a cuff at the graft-vein anastomosis (Venaflo; Bard industries, Tempe, Ariz.) and that of the regular ePTFE graft (Stretch Gore-Tex; Gore, Flagstaff, Ariz.) placed for hemodialysis access.


METHODS
Between January and April 2005, 36 consecutive patients (average age: 63.3 years) underwent ePTFE graft implantation (36 implantations) for hemodialysis at the Vascular Surgery Section of Chang Gung Memorial Hospital. The patients of the study cohort were randomly assigned to two groups based on the graft used: cuffed graft group (Venaflo graft) and non-cuffed standard graft group (Gore-Tex graft). Each patient underwent antegrade venography at the 3-month follow-up to demonstrate the graft outlet stricture. Results of the graft outlet angiography analysis were examined, and all medical records were reviewed at end of the study. The degree of the graft outlet stenosis was compared between the two groups.


RESULTS
Average stenosis of the cuffed graft group and non-cuffed (standard) graft group were 22.76 +/- 26.37%% and 44.95 +/- 27.48%%, respectively; the difference between the two groups was statistically significant (P < 0.05).


CONCLUSIONS
The graft outlet stricture of cuffed ePTFE grafts for hemodialysis 3 months after implantation was less severe than that for the standard ePTFE graft. The correlation between the stricture level and dialysis graft patency requires further clarification.
Liu
Yun-Hen
YH
Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan, ROC.
Hung
Yen-Ni
YN
Hsieh
Hung-Chang
HC
Ko
Po-Jen
PJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D006435:Renal Dialysis / Q000295:instrumentation*
D011138:Polytetrafluoroethylene