Improving longevity of prosthetic dialysis grafts in patients with disadvantaged venous outflow.

Objective: Angioaccess for hemodialysis in an extremity with disadvantaged venous outflow has reduced long-term patency. We hypothesized that arteriovenous bridge graft patency could be improved in patients with disadvantaged venous outflow by preoperative venous duplex mapping.

Methods: The charts of 114 patients who underwent 115 prosthetic arteriovenous bridge grafts were reviewed.

Implantofix vascular access system: an experience with 19 patients.

The use of implantable vascular access devices has increased rapidly in recent years. We have placed the new Implantofix Implantable Drug Delivery System 7500 in 19 patients. The patients reported only minor discomfort.

Implantable venous access devices: an alternative method of extended cancer care.

The advent of totally implantable venous access devices (TIVADs) is changing the method of treatment for those chronically ill patients who require long-term chemotherapy or narcotic infusion. TIVADs eliminate the problem of limited peripheral vein access with little risk of complication. At Good Samaritan Hospital in Cincinnati, Ohio, we have implanted 30 TIVADs (3 Infuse-A-Ports and 27 Port-a-Caths) for a total of 4,502 patient days.

Comparison of autogenous fistula versus expanded polytetrafluoroethylene graft fistula for angioaccess in hemodialysis.

A hundred patients with RCAV fistulas we compared with 100 patients with expanded PTFE fistulas created during the same time period. The fistulas were analyzed to compare early and late thrombosis, life table patency, infection rate, venous hypertension, and vascular steal. There was a significantly greater incidence of early thrombosis in the RCAV fistula group.