Early experience with a novel self-sealing nanofabric vascular graft for early hemodialysis access

Abstract

Aim

To report initial experience regarding the use of novel self-sealing electrospun nanofabric graft.

Material and methods

A total of 21 patients aged between 22 and 64 (male:female ratio = 11:10) underwent AVflo vascular access graft implantation to forearm. Information for patency at 6 and 12 months after the operation was obtained. Cannulation for hemodialysis was allowed 8 h after the operation, as needed.

Results

Cannulation was performed before 12th hour of implantation in two patients, between 12th and 24th postoperative hours in 10 patients and between 12th and 24th postoperative hours in the remaining nine patients. Primary patency was 17/21 (80.9%) at 6th month and 15/21 (71.4%) at 12th month. Secondary patency was 19/21 (90.4%) at sixth month and 17/21 (80.9%) at 12th month.

Conclusion

AVflo self-sealing graft allows for early cannulation after implantation and thus may potentially eliminate the need for central venous catheters in selected patients.

Keywords

Vascular access hemodialysis arterivenous fistula graft electrospun

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References

Ortiz

Covic

Fliser

. Epidemiology, contributors to, and clinical trials of mortality risk in chronic kidney failure. Lancet 2014; 383: 1831–1843.

Ravani

Palmer

Oliver

. Associations between hemodialysis access type and clinical outcomes: a systematic review. J Am Soc Nephrol 2013; 24: 465–473.

Koncicki

HM1

Swidler

. Decision making in elderly patients with advanced kidney disease. Clin Geriatr Med 2013; 29: 641–655.

Lin

Chen

Huang

. Increased blood loss from access cannulation site during hemodialysis is associated with anemia and arteriovenous graft use. Ther Apher Dial 2014; 18: 51–56.

Gupta

Yassin

. Infection and hemodialysis access: An updated review. Infect Disord Drug Targets 2013; 13: 196–205.

Xue

Wang

. Hemodialysis access usage patterns in the incident dialysis year and associated catheter-related complications. Am J Kidney Dis 2013; 61: 123–130.

Bradbury

Chen

Furniss

. Conversion of vascular access type among incident hemodialysis patients: Description and association with mortality. Am J Kidney Dis 2009; 53: 804–814.

Gauly

Parisotto

Skinder

. Vascular access cannulation in hemodialysis patients – A survey of current practice and its relation to dialysis dose. J Vasc Access 2011; 12: 358–364.

Wijeyaratne

Kannangara

. Safety and efficacy of electrospun polycarbonate-urethane vascular graft for early hemodialysis access: First clinical results in man. J Vasc Access 2011; 12: 28–35.

10.

Ferraresso

Bertoli

Nobili

. Early experience with a newly developed electrospun polycarbonate-urethane vascular graft for hemodialysis access. J Vasc Access 2013; 14: 252–256.

11.

Karatepe

Altinay

Yetim

. A novel electrospun nano-fabric graft allows early cannulation access and reduces exposure to central venous catheters. J Vasc Access 2013; 14: 273–280.