Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

A Five-Year Experience With the Bovine Heterograft for Vascular Access

A Five-Year Experience With the Bovine Heterograft for Vascular Access Abstract • We retrospectively analyzed 385 bovine heterografts inserted in 331 patients receiving dialysis to determine patency and complication rates. Eighty-two grafts were inserted in diabetics, 303 in nondiabetics; 129 were primary grafts, 256 secondary. There were 251 "distal" grafts using the distal radial artery and 134 "proximal" grafts using the distal brachial artery (127 grafts) or the superficial femoral artery (seven grafts). During this five-year interval, 209 complications were identified with the most prevalent being thrombosis (160), aneurysms (18), and puncture site (18) or wound (eight) infections. An aggressive surgical approach to these complications prolonged graft patency, as evidenced by only 82 irreversible graft failures. The overall patency rate at one through four years was 79%, 69%, 63%, and 51% respectively. One- and two-year patency for diabetics (81%, 74%) vs nondiabetics (78%, 70%), primary (85%, 77%) vs secondary grafts (73%, 64%), and proximal (80%, 66%) vs distal grafts (75%, 64%) were not significantly different. Long-term patency was unaffected by diabetes, previous access procedures, or graft location. (Arch Surg 1986;121:941-944) References 1. Brescia MJ, Cimino JE, Appel K, et al: Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula . N Engl J Med 1966;275;1089-1092.Crossref 2. Dardik H, Ibrahim IM, Dardik I: Arteriovenous fistulas constructed with modified human umbilical cord vein graft . Arch Surg 1976;111:60-62.Crossref 3. Chinitz JL, Yokoyama T, Bower R, et al: Self-sealing prosthesis for arteriovenous fistula in man . Trans Am Soc Artif Intern Organs 1972;18: 452-457.Crossref 4. Hurt AV, Batello-Cruz MB, Skipper BJ, et al: Bovine carotid artery heterografts versus polytetrafluoroethylene grafts . Am J Surg 1983;146: 844-847.Crossref 5. Etheredge EE, Sicard GE, Anderson CB, et al: Salvage operations for malfunctioning polytetrafluoroethylene hemodialysis access grafts . Surgery 1983;94:464-470. 6. Tellis VA, Kohlberg WI, Bhat DJ, et al: Expanded polytetrafluoroethylene graft fistula for chronic hemodialysis . Ann Surg 1980;189:101-105.Crossref 7. Rosenthal JJ, Spigelman A, Gaspar MR, et al: Problems with bovine heterografts for hemodialysis . Am J Surg 1975;130:182-188.Crossref 8. Johnson JM, Baker LD, Williams T: Expanded polytetrafluoroethylene: A subcutaneous conduit for hemodialysis . Trans Am Soc Artif Intern Organs 1976;22:382-387. 9. Butler HG, Baker LD, Johnson JM: Vascular access for chronic hemodialysis: Polytetrafluoroethylene (PTFE) versus bovine heterograft . Am J Surg 1977;134:791-793.Crossref 10. Anderson CB, Sicard GA, Etheredge EE: Bovine carotid artery and expanded polytetrafluoroethylene grafts for hemodialysis vascular access . J Surg Res 1980;29:184-188.Crossref 11. Garvin PJ, Codd JE: Aggressive approach to late thrombosis of bovine heterografts . Arch Surg 1979;190:743-745. 12. Garvin PJ, Castaneda MA, Codd JE: Etiology and management of bovine graft aneurysms . Arch Surg 1982;117:281-284.Crossref 13. Hertzer NR, Beven EG: Venous access using bovine carotid heterografts . Arch Surg 1978;113:696-700.Crossref 14. Mohaideen AM, Mendivil J, Avram MM, et al: Arteriovenous access utilizing modified bovine arterial grafts for hemodialysis . Ann Surg 1977;186:643-650.Crossref 15. Oakes DO, Spees EK, Light JA, et al: A three-year experience using modified bovine arterial heterografts for vascular access in patients requiring hemodialysis . Ann Surg 1978;187:423-429.Crossref 16. Burbridge GE, Biggers JA, Remmers AR, et al: Late complications and results of bovine xenografts . Trans Am Soc Artif Intern Organs 1976;22:377-379. 17. Merickel JH, Anderson RC, Knutson R, et al: Bovine carotid artery shunts in vascular access surgery . Arch Surg 1974;109:245-250.Crossref 18. Wellington JL: Expanded polytetrafluoroethylene prosthetic grafts for blood access in patients on dialysis . Can J Surg 1978;21:420-422. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

A Five-Year Experience With the Bovine Heterograft for Vascular Access

Download PDF
4 pages

Loading next page...
 
/lp/american-medical-association/a-five-year-experience-with-the-bovine-heterograft-for-vascular-access-Babx0Knlox

References (25)

Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1986.01400080087016
Publisher site
See Article on Publisher Site

Abstract

Abstract • We retrospectively analyzed 385 bovine heterografts inserted in 331 patients receiving dialysis to determine patency and complication rates. Eighty-two grafts were inserted in diabetics, 303 in nondiabetics; 129 were primary grafts, 256 secondary. There were 251 "distal" grafts using the distal radial artery and 134 "proximal" grafts using the distal brachial artery (127 grafts) or the superficial femoral artery (seven grafts). During this five-year interval, 209 complications were identified with the most prevalent being thrombosis (160), aneurysms (18), and puncture site (18) or wound (eight) infections. An aggressive surgical approach to these complications prolonged graft patency, as evidenced by only 82 irreversible graft failures. The overall patency rate at one through four years was 79%, 69%, 63%, and 51% respectively. One- and two-year patency for diabetics (81%, 74%) vs nondiabetics (78%, 70%), primary (85%, 77%) vs secondary grafts (73%, 64%), and proximal (80%, 66%) vs distal grafts (75%, 64%) were not significantly different. Long-term patency was unaffected by diabetes, previous access procedures, or graft location. (Arch Surg 1986;121:941-944) References 1. Brescia MJ, Cimino JE, Appel K, et al: Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula . N Engl J Med 1966;275;1089-1092.Crossref 2. Dardik H, Ibrahim IM, Dardik I: Arteriovenous fistulas constructed with modified human umbilical cord vein graft . Arch Surg 1976;111:60-62.Crossref 3. Chinitz JL, Yokoyama T, Bower R, et al: Self-sealing prosthesis for arteriovenous fistula in man . Trans Am Soc Artif Intern Organs 1972;18: 452-457.Crossref 4. Hurt AV, Batello-Cruz MB, Skipper BJ, et al: Bovine carotid artery heterografts versus polytetrafluoroethylene grafts . Am J Surg 1983;146: 844-847.Crossref 5. Etheredge EE, Sicard GE, Anderson CB, et al: Salvage operations for malfunctioning polytetrafluoroethylene hemodialysis access grafts . Surgery 1983;94:464-470. 6. Tellis VA, Kohlberg WI, Bhat DJ, et al: Expanded polytetrafluoroethylene graft fistula for chronic hemodialysis . Ann Surg 1980;189:101-105.Crossref 7. Rosenthal JJ, Spigelman A, Gaspar MR, et al: Problems with bovine heterografts for hemodialysis . Am J Surg 1975;130:182-188.Crossref 8. Johnson JM, Baker LD, Williams T: Expanded polytetrafluoroethylene: A subcutaneous conduit for hemodialysis . Trans Am Soc Artif Intern Organs 1976;22:382-387. 9. Butler HG, Baker LD, Johnson JM: Vascular access for chronic hemodialysis: Polytetrafluoroethylene (PTFE) versus bovine heterograft . Am J Surg 1977;134:791-793.Crossref 10. Anderson CB, Sicard GA, Etheredge EE: Bovine carotid artery and expanded polytetrafluoroethylene grafts for hemodialysis vascular access . J Surg Res 1980;29:184-188.Crossref 11. Garvin PJ, Codd JE: Aggressive approach to late thrombosis of bovine heterografts . Arch Surg 1979;190:743-745. 12. Garvin PJ, Castaneda MA, Codd JE: Etiology and management of bovine graft aneurysms . Arch Surg 1982;117:281-284.Crossref 13. Hertzer NR, Beven EG: Venous access using bovine carotid heterografts . Arch Surg 1978;113:696-700.Crossref 14. Mohaideen AM, Mendivil J, Avram MM, et al: Arteriovenous access utilizing modified bovine arterial grafts for hemodialysis . Ann Surg 1977;186:643-650.Crossref 15. Oakes DO, Spees EK, Light JA, et al: A three-year experience using modified bovine arterial heterografts for vascular access in patients requiring hemodialysis . Ann Surg 1978;187:423-429.Crossref 16. Burbridge GE, Biggers JA, Remmers AR, et al: Late complications and results of bovine xenografts . Trans Am Soc Artif Intern Organs 1976;22:377-379. 17. Merickel JH, Anderson RC, Knutson R, et al: Bovine carotid artery shunts in vascular access surgery . Arch Surg 1974;109:245-250.Crossref 18. Wellington JL: Expanded polytetrafluoroethylene prosthetic grafts for blood access in patients on dialysis . Can J Surg 1978;21:420-422.

Journal

Archives of Surgery – American Medical Association

Published: Aug 1, 1986

There are no references for this article.