Surgical Procedure Using a Polyurethane Graft and ePTFE Graft to Access Blood Vessels

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  • 透析用ポリウレタン製人工血管を用いたコンポジットグラフト手技

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Objectives: We designed a surgical procedure using an expanding polytetrafluoroethylene (ePTFE) synthetic vascular prosthesis together with a Thoratec graft, to access a blood vessel and rectify a fault which developed in the Thoratec graft. We also investigated the results of the initial operation and mid-term follow up. Methods: From July 2005 to April 2010, we performed vascular access procedures in the forearms of 97 patients (58 women, 39 men). We used the straight portion of a Thoratec graft in an arterial anastomosis. An ePTFE graft was used in the loop portion and in the remainder of the venous side anastomosis. We retrospectively reviewed the case notes of all patients and calculated the patency rates using the Kaplan-Meier medthod. The mean follow-up period was 1.6 years. Results: After the surgical removal of a thrombus or extending graft, there were 3 permanent obstructions of grafts, but no other major complications. In the mid-term, major complications were graft infection in 11 cases, and venous hypertension and steal syndrome in 2 cases each. The rate of secondary patency was 94% at 1 year, 92% at 2 years and 89% at 3 years. Conclusion: This procedure offers excellent patency rates with acceptable major complication rates and should be appropriate to rectify Thoratec graft faults.

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