"Growth factor" technique using expanded polytetrafluoroethylene monofilament for arteriovenous fistulae

We employed the "growth factor" technique first described by Starzl et al. to construct 12 consecutive end-to-end arteriovenous wrist fistulas (AVWF) for chronic hemodialysis, using expanded polytetrafluoroethylene (ePTFE) monofilament (Gore-Tex) as the suture material. A complete migration of the "growth factor" loop through the vessel walls was observed and immediate patency of the AVWF was achieved in all patients. Although AVWF thrombosis developed in one patient, no other complications were observed in the early postoperative period. The 2-month AVWF patency rate was 90.9%. The ePTFE sutures demonstrated an adequate sliding property which make this monofilament a satisfactory material for vascular anastomosis constructed using this technique.