title: Use of the Vectra polyetherurethaneurea graft for dialysis access in HIV-positive patients with end-stage renal disease.
abstract: The primary objective of this study was to establish the safety, efficacy, infection rate, and patency of the Vectra graft (polyetherurethaneurea) for dialysis access in patients diagnosed with human immunodeficiency virus (HIV) and end-stage renal disease. The Vectra graft has a unique self-sealing property; therefore we hypothesize that these patients will have fewer infections. A Vectra graft was implanted in 30 consecutive HIV-positive patients without sufficient veins for an autologous fistula. These surgeries were carried out over a 2.5-year period. Primary graft patency was 42% at 12 months and 3 (10%) of the grafts developed infection. This rate of graft infection was less (10% vs 45%) than both our prior experience and published reports using polytetrafluorothene bridge grafts. The unique self-sealing property of the Vectra graft minimizes the development of perigraft hematoma with repetitive needle cannulation and in the immunosuppressed HIV-positive patient, may account for the observed decrease in dialysis access infection.
authors.affiliation: Division of Vascular Surgery, University of Miami School of Medicine, Miami, Florida, USA. fschild@med.miami.edu
authors.forename: A Frederick
authors.initials: AF
authors.lastname: Schild
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Perez
authors.forename: Erin
authors.initials: E
authors.lastname: Gillaspie
authors.forename: Asha R
authors.initials: AR
authors.lastname: Patel
authors.forename: Karlene
authors.initials: K
authors.lastname: Noicely
authors.forename: Neyton
authors.initials: N
authors.lastname: Baltodano
mesh_terms: D000328:Adult; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000295:instrumentation*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology; D006679:HIV Seropositivity / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D011140:Polyurethanes; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000209:etiology; D006435:Renal Dialysis; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D011140:Polyurethanes; C044690:polyetherurethane urea