Initial experience with the Gore® Acuseal graft for prosthetic vascular access

Area of Science:

• Vascular Surgery
• Nephrology
• Biomaterials Science

Background:

• End-stage renal disease (ESRD) necessitates reliable vascular access for hemodialysis.
• Prosthetic vascular access (pVA) grafts are crucial for patients with inadequate native vasculature.
• The Gore® Acuseal graft is a newer option for pVA, requiring evaluation of its short-term efficacy and safety.

Purpose of the Study:

• To evaluate the short-term clinical outcomes of the Gore® Acuseal graft in patients undergoing hemodialysis.
• To assess patency rates, time to cannulation, and complication incidence associated with this new ePTFE graft.

Main Methods:

• A prospective study included 30 patients receiving Gore® Acuseal (expanded Polytetrafluoroethylene [ePTFE]) tri-layer grafts.
• Graft configurations included radial-basilic, brachial-basilic, and femoro-femoral, among others.
• Outcomes monitored included primary and secondary patency, time to first cannulation, and complications over a 12-month follow-up period.

Main Results:

• Thirty ePTFE tri-layer heparin-bonded grafts were implanted in 30 patients.
• Mean follow-up was 6.3 months. Mean time to first cannulation was 2.4 days.
• Primary patency was 68.0% at 6 and 12 months; secondary patency was 93.3% at 6 and 12 months. No pseudoaneurysms, bleeding, seromas, or infections occurred.

Conclusions:

• The Gore® Acuseal graft demonstrated utility and safety in this cohort.
• Early cannulation was consistently achieved without structural complications.
• Short-term primary and secondary patency rates were satisfactory, supporting its use for prosthetic vascular access.