Annals of vascular surgery · 2021
Use of Heparin-Bonded Expanded Polytetrafluoroethylene Grafts for Renal Artery Reconstruction.
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Yamamoto Yohei, Uchiyama Hidetoshi, Oonuki Masahiro
Аннотация
BACKGROUND: The purpose of this study was to analyze our initial experience in renal artery reconstruction with heparin-bonded expanded polytetrafluoroethylene (ePTFE) grafts.
METHODS: The authors retrospectively reviewed the data of consecutive patients who received open renal reconstruction with a heparin-bonded ePTFE graft at our institution between January 2014 and December 2019.
RESULTS: A total of 22 renal reconstructions with a heparin-bonded ePTFE graft were performed in 17 consecutive patients. In all cases, renal reconstruction was a concomitant procedure during surgical or endovascular aortic procedures. Postoperative complications within 30 days were observed in 9 (53%) patients, including acute kidney injury (n = 6), pneumonia (n = 1), retrograde type B aortic dissection (n = 1), and lower limb ischemia (n = 1). The 30-day mortality rate was 0%. In a median follow-up period of 32 (19-39) months, all grafts were patent without re-intervention. Six patients with preoperative stage 2 chronic kidney disease progressed to stage 3 during follow-up. No patient required temporary or permanent hemodialysis. One patient died from intestinal ischemia at 23 months after surgery.
CONCLUSIONS: This study showed that the patency after open renal reconstruction with a heparin-bonded ePTFE graft was excellent, with acceptable renal outcomes, and demonstrates its safety as a concomitant procedure during an aortic procedure. Heparin-bonded ePTFE grafts are a feasible and effective choice for open renal reconstruction in contemporary practice.
METHODS: The authors retrospectively reviewed the data of consecutive patients who received open renal reconstruction with a heparin-bonded ePTFE graft at our institution between January 2014 and December 2019.
RESULTS: A total of 22 renal reconstructions with a heparin-bonded ePTFE graft were performed in 17 consecutive patients. In all cases, renal reconstruction was a concomitant procedure during surgical or endovascular aortic procedures. Postoperative complications within 30 days were observed in 9 (53%) patients, including acute kidney injury (n = 6), pneumonia (n = 1), retrograde type B aortic dissection (n = 1), and lower limb ischemia (n = 1). The 30-day mortality rate was 0%. In a median follow-up period of 32 (19-39) months, all grafts were patent without re-intervention. Six patients with preoperative stage 2 chronic kidney disease progressed to stage 3 during follow-up. No patient required temporary or permanent hemodialysis. One patient died from intestinal ischemia at 23 months after surgery.
CONCLUSIONS: This study showed that the patency after open renal reconstruction with a heparin-bonded ePTFE graft was excellent, with acceptable renal outcomes, and demonstrates its safety as a concomitant procedure during an aortic procedure. Heparin-bonded ePTFE grafts are a feasible and effective choice for open renal reconstruction in contemporary practice.
Предметные рубрики MeSH
AgedAnticoagulantsAortic Aneurysm, AbdominalAortic Aneurysm, ThoracicBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationCoated Materials, BiocompatibleFemaleHeparinHumansMaleMiddle AgedPolytetrafluoroethylenePostoperative ComplicationsProsthesis DesignPlastic Surgery ProceduresRenal ArteryRenal Artery ObstructionRetrospective StudiesTime FactorsTreatment OutcomeVascular Patency