Objective: The re-establishment of patency in a stenosed or thrombosed native arteriovenous fistula (AVF) is fundamental to regaining adequate hemodialysis through the same cannulable vein. Many surgeons have been reluctant to use even small segments of synthetic grafts in AVF revisions because of a perception that these would lead to poor results; however, studies comparing various treatment options are scarce. This study compared the use of short (<6 cm) polytetrafluoroethylene (PTFE) segments with pure autologous repair in stenosed or thrombosed native fistulas.
Methods: The cumulative postintervention primary patency rates of two groups of hemodialysis patients receiving different surgical revision operations of their vascular accesses were prospectively compared. Group I (n = 30) comprised patients who presented with stenosed or thrombosed native fistulas and received short (2 to 6 cm) interposition PTFE grafts placed after the stenosed or thrombosed outflow vein segment was resected. These short PTFE grafts were not used for cannulation. Group II (n = 29) comprised patients who presented with dysfunctional or failed AVFs and underwent various types of pure autogenous corrections. AVF dysfunction or thrombosis was detected with clinical examination and color duplex ultrasound scanning. In all cases, on-table arteriography-fistulography was performed before surgical repair. Access adequacy was assessed in all patients postoperatively after the first puncture and every month thereafter (mean follow up 16.7 months).
Results: No statistically significant difference in patency was observed between the two groups. Postintervention cumulative patencies were 100%, 88%, and 82% for group I and 90%, 82%, and 71% for group II at 6, 12, and 18 months, respectively ( P = .8).
Conclusions: Short (<6 cm) interposition PTFE segments used for the revision of failing or failed AVFs compare favorably to purely native repair and do not alter the autologous behavior of the initial access. These short PTFE revisions resulted in satisfactory midterm primary patency without further consumption of the venous capital by harvesting segments of vein from other locations and without compromising more proximal access sites. This practice is recommended and is justified as part of an aggressive access salvage policy addressed by many authors so far.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.jvs.2004.10.034 | DOI Listing |
Ann Thorac Surg Short Rep
December 2024
Institute for Integrated Life Skills, LLC, Bermuda Run, North Carolina.
Background: The expanded polytetrafluoroethylene (ePTFE) valved conduit (VC) has been reported for pulmonary valve replacement (PVR). The purpose of this study was to review long-term outcomes of our trileaflet ePTFE VC.
Methods: This multicenter study was performed with institutional review board approval from each institution.
Nanoscale
December 2024
School of Marine Engineering Equipment, Zhejiang Ocean University, Zhoushan 316022, China.
It is urgently desired to develop high-performance wind energy collectors to power numerous microelectronic devices along with the Internet of Things (IoT). A roller-type triboelectric nanogenerator (R-TENG) based on rotational friction between wool and stacked interfaces is proposed and efficiently used for harvesting wind energy. Wool, an electropositive and flexible material, is utilized in the design, effectively reducing abrasion on the contact surface and adjusting the output in response to varying compression levels.
View Article and Find Full Text PDFSensors (Basel)
November 2024
State Key Laboratory of ASIC and System, Key Laboratory for Information Science of Electromagnetic Waves (MoE), School of Information Science and Technology, Fudan University, Shanghai 200433, China.
In terahertz communication systems, lens antennas used in transceivers are basically plano-convex dielectric lenses. The size of a plano-convex lens increases as the aperture increases, and thinner lenses have longer focal lengths. Through theory and simulation, we designed a Fresnel lens suitable for the terahertz band to meet the requirements of large aperture and short focal length, and simulated the performance, advantages, and disadvantages of the terahertz Fresnel lens.
View Article and Find Full Text PDFTransplant Proc
December 2024
Surgery Department, Section of Transplantation, Armed Forces Hospitals, Southern Region, Khamis Mushayte, KSA.
Short donor renal artery during nephrectomy poses a technical challenge. We present a main renal artery (RA) reconstruction case in Living-donor kidney transplantation (LDKT) using an extension polytetrafluoroethylene vascular graft(PTFE). A 57-year-old man received LDKT from his son.
View Article and Find Full Text PDFACS Appl Bio Mater
December 2024
Department of Materials Science, School of Chemistry, Madurai Kamaraj University, Madurai 625 021, India.
In the present study, we demonstrated a cost-effective chia seed-based triboelectric nanogenerator (C-TENG), leveraging the triboelectric properties of chia seeds. The C-TENGs are fabricated with a simple architecture, establishing adaptability, cost effectiveness, and versatility as an ecofriendly harvester of mechanical energy. The C-TENG exhibits open- circuit voltage and short-circuit currents on the order of 501.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!