title: Bovine carotid artery (Artegraft) as a hemodialysis access conduit in patients who are poor candidates for native arteriovenous fistulae.
abstract: Our experience with bovine carotid artery graft (BCAG) for hemodialysis access (Artegraft, North Brunswick, New Jersey) is presented. A review of all patients who underwent placement of BCAG for hemodialysis access at our institution was performed. Between January 2012 and June 2013, 17 BCAGs were placed in 17 patients. Indications included skin compromise, recurrent expanded polytetrafluoroethylene (ePTFE) and catheter infections, immunosuppression, groin placement, and surgeon's choice. Actuarial primary, primary-assisted, and secondary patency rates at 18 months were 73.3%, 67%, and 89%, respectively. One immunosuppressed patient developed a vancomycin-resistant enterococcus graft infection and required removal 2 months following the initial procedure. We conclude that BCAG can be used as an alternative to ePTFE for angioaccess in patients with no available superficial vein in high-risk patients with low morbidity and good functional patency. Our 1-year patency rates were superior to ePTFE as reported in the contemporary peer-reviewed literature.
authors.affiliation: Division of Vascular Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Harlander-Locke
authors.affiliation: Division of Vascular Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA jcjimenez@mednet.ucla.edu.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Jimenez
authors.affiliation: Division of Vascular Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Lawrence
authors.affiliation: Division of Vascular Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Hugh A
authors.initials: HA
authors.lastname: Gelabert
authors.affiliation: Division of Vascular Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Brian G
authors.initials: BG
authors.lastname: Derubertis
authors.affiliation: Division of Vascular Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Rigberg
authors.affiliation: Division of Vascular Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Farley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000295:instrumentation*; D001705:Bioprosthesis / Q000009:adverse effects; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D002339:Carotid Arteries / Q000637:transplantation*; D002417:Cattle; D020878:Device Removal; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000601:surgery; D064593:Heterografts; D006801:Humans; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000601:surgery; D006435:Renal Dialysis; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: angioaccess; bovine; conduit; hemodialysis; immunosuppression; infection