title: A helical PTFE arteriovenous access graft to swirl flow across the distal anastomosis: results of a preliminary clinical study.
abstract: Intimal hyperplasia develops preferentially in regions where the blood flow is stagnant and wall shear stress low. The small amplitude helical geometry of the SwirlGraft was designed to ensure physiological-type swirling flow, and thus suppress the triggers. We report the first conceptual testing of the SwirlGraft. Primary, assisted primary and secondary patency rates at 6 months in 20 patients were 57.9+/-11.4%, 84.4+/-8.3% and 100+/-0.0%. There was angiographic evidence of reduction of helical geometry in a proportion of the grafts. The helical graft is associated with high assisted primary and secondary patency. Elaboration of the surgical implantation techniques and an improved SwirlGraft design can be expected to exploit the advantages of the helical concept.
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: H J T A M
authors.initials: HJ
authors.lastname: Huijbregts
authors.forename: P J
authors.initials: PJ
authors.lastname: Blankestijn
authors.forename: C G
authors.initials: CG
authors.lastname: Caro
authors.forename: N J W
authors.initials: NJ
authors.lastname: Cheshire
authors.forename: M T C
authors.initials: MT
authors.lastname: Hoedt
authors.forename: R P
authors.initials: RP
authors.lastname: Tutein Nolthenius
authors.forename: F L
authors.initials: FL
authors.lastname: Moll
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001132:Arm / Q000098:blood supply*; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000295:instrumentation*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D003251:Constriction, Pathologic / Q000209:etiology; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D011474:Prosthesis Design; D012039:Regional Blood Flow; D006435:Renal Dialysis / Q000379:methods*; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D011138:Polytetrafluoroethylene