Open AccessExperience with Dacron Graft Arteriovenous Fistulas for Dialysis Access
Author(s) -
James F. Burdick,
Wendell J. Scott,
A. Benedict Cosimi
Publication year - 1978
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-197803000-00009
Subject(s) - medicine , hemodialysis , dialysis , arteriovenous fistula , surgery , brachial artery , thrombosis , fistula , hemodynamics , population , complication , occlusion , cephalic vein , myocardial infarction , cardiology , vein , blood pressure , environmental health
The technique, hemodynamics, and results of a new, more successful Filamentous Velour Dacron graft dialysis fistula between brachial artery and axillary vein are described. Hemodialysis has been successfully instituted in 15/16 patients. One graft was removed for infection and one for overlying skin erosion. There have been five episodes of thrombosis, all with successful restoration to function. After a median nine-month follow-up, nine of 16 grafts have been complication-free and 13 of 16 remain functional or functioned until the time of death. Hemodynamic studies revealed that with high flows (even 1900 cc/min), there was no evidence of cardiac failure or peripheral "steal". One patient with low flow (less than 300 cc/min) had transient distal ischemic symptoms and another with similar flow later developed arterial occlusion distal to the fistula after suffering a myocardial infarction. With increased attention to technical details observed in this early experience, it appears that greater than 80% of these grafts should provide long-term dialysis access for this difficult patient population.