Infectious complications of arteriovenous ePTFE grafts for hemodialysis.
BACKGROUND
Insufficient venous vasculature disallows autologous arteriovenous fistula creation. In this case an arteriovenous conduit of expanded polytetrafluoroethylene (ePTFE) interponed between artery and vein is used for hemodialysis. Although arteriovenous graft infection is an infrequent complication, infected grafts cannot be used for hemodialysis and can cause infection, sepsis and bleeding. Treatment options remain limited but the general approach is to maintain functional angioaccess and to eradicate infection.


OBJECTIVE
To summarize current knowledge of the prevention and treatment of arteriovenous graft infection.


METHODS
Literature review.


CONCLUSIONS
ePTFE graft present an unreplaceable material used for angioaccess in patients with an insufficient venous vasculature. A number of risk factors causing graft infection is known. Since hemodialysis patients are a high-risk group, an effective strategies for graft infection prevention and early diagnosis should be determined. Among the most important risk factors belong surgical procedure, recurrent venipuncture and other infection disease. The prostheses should be removed when infected, especially in the presence of sepsis. In case of "localized infection", the prostheses can be removed partially only under the condition of careful patient selection and subsequent follow-up.
Bachleda
Petr
P
2nd Department of Surgery, University Hospital Olomouc, Czech Republic.
Utikal
Petr
P
Kalinova
Lucie
L
Köcher
Martin
M
Cerna
Marie
M
Kolar
Milan
M
Zadrazil
Josef
J
D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects* / Q000295:instrumentation; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D006801:Humans; D011138:Polytetrafluoroethylene; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000517:prevention & control; D006435:Renal Dialysis
D011138:Polytetrafluoroethylene