title: Long-term complication and patency rates of Vectra and IMPRA Carboflo vascular access grafts with aggressive monitoring, surveillance and endovascular management.
abstract: The purpose of this study is to compare infection, pseudoaneurysm formation and patency rates during long-term follow-up of polyurethane and polytetrafluoroethylene (PTFE) vascular access grafts maintained with contemporary endovascular methods. During a 34-month period, 239 polyurethane and 125 carbon-impregnated PTFE vascular access grafts were placed in 324 consecutive patients. Thirty-six patients (9.9%) developed a pseudoaneurysm (anastomotic, n = 6 or at the needle-stick site, n = 30). An additional 19 patients (5.2%) required graft excision for infection. Three-year graft infection and pseudoaneurysm formation (at needle-stick site) rates were similar in polyurethane and PTFE grafts (11% versus 8%, P = 0.61, and 17% versus 23%, P = 0.72, respectively). Three-year secondary patency was better in polyurethane than PTFE grafts (69% versus 57%, respectively, P = 0.012). Straight upper arm polyurethane grafts had the best secondary patency (P = 0.001). Contemporary long-term secondary patency of vascular access grafts is satisfactory. Further follow-up is necessary to compare late infection and pseudoaneurysm formation rates.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Kakkos
authors.forename: D
authors.initials: D
authors.lastname: Topalidis
authors.forename: R
authors.initials: R
authors.lastname: Haddad
authors.forename: G K
authors.initials: GK
authors.lastname: Haddad
authors.forename: A D
authors.initials: AD
authors.lastname: Shepard
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000453:epidemiology; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011138:Polytetrafluoroethylene; D011140:Polyurethanes; D016459:Prosthesis-Related Infections / Q000453:epidemiology; D006435:Renal Dialysis; D058017:Vascular Grafting / Q000009:adverse effects*; D014654:Vascular Patency
chemical_list: D011140:Polyurethanes; C528226:thoralon; D011138:Polytetrafluoroethylene