CASE REPORT


Comparison of Acuseal and Standard ePTFE Vascular Grafts for Hemodialysis: A Retrospective Case Series



Louisa M.S. Gerhardt1, *, Andreas Bock1, Regula Marti2, Stephan Segerer1
1 Division of Nephrology, Dialysis and Transplantation, Kantonsspital Aarau, Aarau, Switzerland
2 Department of Surgery, Kantonsspital Aarau, Aarau, Switzerland


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Creative Commons License
© 2019 Gerhardt et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Division of Nephrology Kantonsspital Aarau Tellstrasse 25 CH-5001 Aarau, Switzerland; Tel: ++41 628386450; Fax: ++41 628386552; E-mail: louisa.gerhardt@ksa.ch


Abstract

Background:

Grafts, which allow early cannulation have been increasingly used to avoid starting dialysis via tunneled hemodialysis catheters. As we noted graft failures in patients with early cannulation grafts, we reviewed the outcome of these grafts and compared it to ePTFE grafts.

Materials and Methods:

We retrospectively analyzed time to first intervention, primary and secondary patency rates as well as the number of interventions needed to maintain patency in patients who received an early cannulation graft (GORE® ACUSEAL, acuseal) or an ePTFE (GORE-TEX®) vascular graft between January 2016 and November 2017 in our medical center.

Results:

12 patients who had received an acuseal vascular graft were compared with 13 patients with an ePTFE vascular graft. The mean time to first intervention was similar in both groups. On average 0.33 interventions per graft were needed per month to maintain patency in the acuseal group, and 0.08 in the ePTFE group (p = 0.02). The primary patency rate did not differ significantly between the groups. The secondary patency rate at the end of the observation period was significantly worse in the acuseal group (p = 0.02). Four acuseal grafts were lost after a mean of 202 days, whereas none of the ePTFE grafts was lost.

Conclusion:

Our data is consistent with our clinical impression of an increased number of interventions and lower longevity of the acuseal vascular graft. These data need conformation in a larger cohort.

Keywords: Acuseal vascular graft, Early cannulation, Hemodialysis vascular access, Dialysis, Catheters, Tri-layer graft.