A new early cannulation graft for haemodialysis access has been implanted for the first time in Europe on 13 May 2011. The procedure with the Gore Acuseal was carried out at St George’s Hospital, London, UK, by renal surgeon, Eric Chemla.
“The Gore Acuseal is a new triple layer PTFE graft yet very soft and easy to handle that can be used for dialysis almost immediately after implant,” said Chemla. He told Vascular News that the graft was used on a patient who had lost vascular access a day earlier and was not suitable for a central venous catheter insertion as their internal jugular veins were occluded.
“As the patient is diabetic our nephrology colleagues were not keen on any femoral route. Reviewing the different scans performed it was obvious that the fistula that occluded 24 hours earlier was not salvageable and that the only alternative when looking at the venous anatomy was a contralateral brachio-axillary bypass graft,” Chemla noted.
The operation was performed on Friday at 12.30 with no complications.
“The graft was very easy to handle, anastomose and tunnel. In recovery, as we needed to draw some blood to measure the potassium rate after surgery, it was impossible to gain access to any peripheral vein. I authorised the cannulation of the graft that had been implanted minutes earlier. This was done successfully without any complications and the patient was sent back to our unit moments after,” Chemla said.
The following morning (20 hours after the implantation) the patient was dialysed for four hours through the graft successfully and without any complication. The needles used were 17 gauge and a pump speed of 250ml/min was obtained. The time to reach haemostasis after the shift was less than 10min and has been the same over the weeks after the procedure.
The Gore Acuseal Vascular Graft is a prosthetic graft which combines predictable self-sealing with improved handling and a surface bonded with heparin. Featuring expanded polyetrafluoroethylene (ePTFE) on the external and luminal surfaces, the middle layer of the graft is a self-sealing elastomer. This unique construction inhibits blood leakage following suturing of the vascular graft or after the repeated needle cannulations necessary for haemodialysis access treatments.
“It was a very promising debut for Acuseal,” Chemla stated.