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A prospective, randomized comparison of bovine carotid artery and expanded polytetrafluoroethylene for permanent hemodialysis vascular access

Kennealey, Peter T., MD ; Elias, Nahel, MD ; Hertl, Martin, MD ; Ko, Dicken S.C., MD ; Saidi, Reza F., MD ; Markmann, James F., MD, PhD ; Smoot, Elizabeth E., MS ; Schoenfeld, David A., PhD ; Kawai, Tatsuo, MD, PhD

Journal of vascular surgery, 2011-06, Vol.53 (6), p.1640-1648 [Periódico revisado por pares]

New York, NY: Mosby, Inc

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Título:
A prospective, randomized comparison of bovine carotid artery and expanded polytetrafluoroethylene for permanent hemodialysis vascular access
Autor: Kennealey, Peter T., MD ; Elias, Nahel, MD ; Hertl, Martin, MD ; Ko, Dicken S.C., MD ; Saidi, Reza F., MD ; Markmann, James F., MD, PhD ; Smoot, Elizabeth E., MS ; Schoenfeld, David A., PhD ; Kawai, Tatsuo, MD, PhD
Assuntos: Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biocompatible Materials ; Biological and medical sciences ; Blood Vessel Prosthesis ; Emergency and intensive care: renal failure. Dialysis management ; Female ; Graft Survival ; Humans ; Intensive care medicine ; Kidney Failure, Chronic - surgery ; Male ; Medical sciences ; Middle Aged ; Polytetrafluoroethylene ; Prospective Studies ; Renal Dialysis ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Vascular Patency ; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
É parte de: Journal of vascular surgery, 2011-06, Vol.53 (6), p.1640-1648
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-News-1
ObjectType-Feature-3
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Descrição: Background Many patients on hemodialysis do not have adequate anatomy for native arteriovenous fistulas. In these patients, synthetic conduits remain an alternative option for permanent hemodialysis access. We sought to compare the standard cuffed expanded polytetrafluoroethylene (ePTFE) graft with the bovine carotid artery (BCA) graft. Methods This was a prospective, randomized controlled trial that was set in an academic medical center. We enrolled 26 patients in the BCA group and 27 patients in the ePTFE group. Primary, assisted primary, and secondary patency were calculated using the Kaplan-Meier method. Complications were monitored and are reported. Results Although there was no significant difference in secondary patency rates, primary and assisted primary patency rates were significantly higher in BCA than in the ePTFE grafts (60.5% vs 10.1% and 60.5% vs 20.8% at 1 year, respectively). The BCA graft survival advantage was most profound in the upper arm grafts with significantly higher primary and assisted patency rates ( P < .0001 and .0005, respectively). The total number of interventions (upper arm grafts) and total number of angioplasties (overall and upper arm) required to maintain patency were significantly fewer in the BCA group. The most common complication was graft thrombosis which occurred 0.34 ± 0.09 times per patient year in the BCA group compared to 0.77 ± 0.16 times per patient year in the ePTFE group, P = .01. Conclusion The BCA graft is an excellent option for patients on hemodialysis that are not suitable for native arteriovenous fistulas, as these grafts required fewer interventions than the ePTFE grafts to maintain patency.
Editor: New York, NY: Mosby, Inc
Idioma: Inglês

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A prospective, randomized comparison of bovine carotid artery and expanded polytetrafluoroethylene for permanent hemodialysis vascular access

Kennealey, Peter T., MD ; Elias, Nahel, MD ; Hertl, Martin, MD ; Ko, Dicken S.C., MD ; Saidi, Reza F., MD ; Markmann, James F., MD, PhD ; Smoot, Elizabeth E., MS ; Schoenfeld, David A., PhD ; Kawai, Tatsuo, MD, PhD

New York, NY: Mosby, Inc

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