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A pilot study comparing bovine mesenteric artery and expanded polytetrafluoroethylene grafts as non-autogenous hemodialysis options

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posted on 2018-12-05, 03:23 authored by Bruno Morisson, Antonio Luiz de Araújo, Leonardo de Oliveira Harduin, Eglina Filgueiras Porcari, Rossano Kepler Alvim Fiorelli, Stenio Karlos Alvim Fiorelli, Jose Marcos Braz Serafim, Julio Cesar Peclat de Oliveira

Abstract Background Many dialysis patients do not have the necessary conditions for construction of a native arteriovenous fistula (AVF). Expanded Polytetrafluoroethylene (ePTFE) vascular prostheses are the most widely-used option, but it is known that they are inferior to native vein AVFs. Objectives To identify a graft with superior performance to ePTFE, comparing their results with those of AVFs made from bovine mesenteric arteries treated with L-Hydro technology (Labcor Laboratories ®). Methods A prospective and controlled study of 10 patients with AVFs constructed with ePTFE and 10 patients with L-Hydro bioprostheses, matched for comorbidities. The variables studied were: primary patency, assisted primary patency, and secondary patency, surgical manipulability, and prevalence of infections. The performance of prostheses was assessed by duplex-scan and repeated consultations with health professionals at hemodialysis clinics. The chi-square test was used for statistical analysis. Results After 1 year of postoperative follow-up, secondary and primary patency rates were higher for L-Hydro than ePTFE AVFs. Fewer interventions were needed to maintain AVF patency in the L-Hydro AVF group. The most common complication was graft thrombosis, which was more frequent in the ePTFE group. While the figures indicate more favorable outcomes in the L-Hydro AVFs, this could not be confirmed with the statistical treatment employed. Conclusions The L-Hydro graft appears to be a valuable alternative option for AVFs, since it seems to require fewer interventions to maintain patency when compared to ePTFE grafts.

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    Jornal Vascular Brasileiro

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