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Lessons learned from the DIASTAT vascular access graft
J M Lohr1, K V James, A T Hearn
1John J. Cranley Vascular Laboratory, Good Samaritan Hospital, Cincinnati, Ohio 45220-2489, USA.
American Journal of Surgery
|August 1, 1996
Summary
The Gore-Tex DIASTAT vascular access graft did not prove ideal for hemodialysis, showing increased edema and earlier thrombosis compared to controls. It did not reduce the need for temporary central venous catheters.
Area of Science:
- Vascular Surgery
- Nephrology
- Medical Devices
Background:
- The search for an optimal vascular access graft for hemodialysis continues.
- Ideal grafts aim for early cannulation and avoidance of temporary central venous catheters.
Purpose of the Study:
- To evaluate the clinical performance of the Gore-Tex DIASTAT vascular access graft.
- To compare its efficacy against a matched control group.
Main Methods:
- Retrospective review of 20 patients receiving the DIASTAT graft.
- Comparison with 20 matched control patients.
- Analysis of graft accessibility, complications, thrombosis, and serviceability.
Main Results:
- DIASTAT grafts did not decrease the need for temporary central venous catheters.
- Increased edema was observed in the DIASTAT group (P = 0.0048).
- Graft thrombosis or revision occurred significantly earlier in the DIASTAT group (18 weeks vs. 56 weeks, P = 0.0058).
- DIASTAT grafts had shorter functional patency (34 weeks vs. 70 weeks, P = 0.0131).
- Early thrombotic events (< 90 days) were significantly higher with DIASTAT grafts (P = 0.0013).
Conclusions:
- The DIASTAT vascular access graft is not the ideal choice for hemodialysis access.
- Its performance is inferior to conventional grafts regarding thrombosis and longevity.