代用血管を用いた透析用シャントについて - E-PTFE(IMPRA)graftを中心として -

Abstract

Subcutaneous A-V conduits were constructed in 18 hemodialysis patients using one bovine graft (SURGIKOS artegraft) and 18 E-PTFE grafts (IMPRA grafts). Nine of these patients were male and 9 female. The ages ranged from 28 to 68 years, with a mean age of 51 years. Thirteen grafts were implanted in the forearm between the brachial artery and vein near the antecubital fossa, 6 grafts in the thigh between the femoral artery and saphenous vein or femoral vein. One bovine graft had been in use for 5 months, developed thrombotic obstruction due to low blood presure because of cardiac tamponade. The patency rate of IMPRA grafts was 82.4 per cent during the period in use of the grafts, from 1 to 24 months, with a mean period of 7 months. Five grafts met thrombotic obstruction and 2 grafts were successfully reopened by thrombectomy. One pseudo aneurysm was observed and corrected by closing the defect of the graft. There was postoperative edema of variable degree which usually resolved within one to 4 weeks following implantation.