Back to the future: how biology and technology could change the role of PTFE grafts in vascular access management.
Although the arteriovenous fistula (AVF) is the preferred mode of dialysis vascular access, AVF maturation failure remains a huge clinical problem, often resulting in a prolonged duration of use of tunneled dialysis catheters. In contrast, polytetrafluoroethylene (PTFE) grafts do not suffer from early failure, but have significant problems with later stenosis and thrombosis. This review will initially summarize the pathology and pathogenesis of PTFE graft dysfunction and will then use this as a basis for describing some novel therapies, which may have the potential to reduce PTFE graft dysfunction. Finally, we will emphasize that the introduction of such therapies could be an important first step toward individualizing overall vascular access care.
Cincinnati VA Medical Center, Cincinnati, Ohio, USA. prabir.roychaudhury@uc.edu
Prabir
P
Roy-Chaudhury
Mahmoud
M
El-Khatib
Begona
B
Campos-Naciff
Davinder
D
Wadehra
Karthik
K
Ramani
Massoud
M
Leesar
Meenakshi
M
Mistry
Yang
Y
Wang
Jenq-Shyong
JS
Chan
Timmy
T
Lee
Rino
R
Munda
D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects*; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D011138:Polytetrafluoroethylene; D011475:Prosthesis Failure; D006435:Renal Dialysis; D013927:Thrombosis / Q000209:etiology
D011138:Polytetrafluoroethylene