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Abstract: FR-PO733

A Prospective Outcome Analysis of the Early Cannulation Graft ACUSEAL® versus the Standard Expanded Polytetrafluoroethylene (ePTFE) Graft in Hemodialysis (HD) Patients

Session Information

Category: Dialysis

  • 704 Dialysis: Vascular Access

Authors

  • Giannikouris, Ioannis Emmanouel, Medifil SA, Athens, Greece
  • Giordano, Giovanni, Vanvitelli L. Hospital, Tramonti, Italy
  • Kyriazis, Periklis Panos, Baystate Medical Center/University of Massachusetts, Springfield, Massachusetts, United States
  • Bacharaki, Dimitra, University Hospital Attikon, Chaidari, Greece
  • Bacchini, Giuseppe, Alessandro Manzoni Hospital Lecco, Lecco, Lombardy, Italy
Background

Our objective was to prospectively compare survival, assisted primary (APR) and secondary (SEC) patency rates of the early cannulation ACUSEAL® and standard ePTFE arteriovenous grafts (AVG) for HD access.

Methods

Incident patients requiring implantation of an AVG for HD initiation or therapy continuation were enrolled between December 2014 and December 2017. Outcome measures were APR, SEC survival, APR and SEC patency rates of these AVG.

Results

A total of 146 HD patients had AVG implanted, 63 were ACUSEAL® and 83ePTFE. For ACUSEAL® APR survival was 190 days and APR patency rate was 31%, 12%, 6% in 12, 24 and 36 months. For ePTFE grafts APR survival was 537 days(p=0.001) and APR patency rate 56%, 43% and 30%. Whereas, SEC survival was 596 days for ACUSEAL® and 1,365 days for ePTFE(p=0.04) while SEC patency was 72%, 49%, 34% and 80%, 70% και 57% in 12, 24 and 36 months, respectively. Wall destruction and lumen stenosis were common findings in removed ACUSEAL®AVG.

Conclusion

The advantage of early cannulation of ACUSEAL® AVG seems to be partly neutralized by the inferior clinical outcomes seen by this graft compared to those of ePTFE AVG. Prospective randomized trials are needed to confirm these preliminary results

Foreign-body giant and mononuclear cell Inflammatory infiltrate penetrating the inner and intermediate graft layers

Polypoid granulation tissue causing wall, layer separation and luminal stenosis