LESSONS LEARNED FROM THE DIASTAT VASCULAR ACCESS GRAFT

BACKGROUND: The vascular community continues to search for the ideal v ascular access graft that will allow early cannulation and avoid tempo rary central venous catheters. METHODS: This is a review of the Cranle y Surgical Associates' experience with the use of the Gore-Tex DIASTAT (W.L. Gore & Associates, Inc., Flagstaff, Arizona) vascular access gr aft in 20 patients compared with 20 control patients matched for age, sex and risk factors. RESULTS: Although the DIASTAT graft is touted fo r early accessibility and decreased need for central venous access, th at was not found to be the case as 14 patients in the DIASTAT group re ceived temporary access catheters. There was significantly more edema in the DIASTAT patients (P = 0.0048). Comparing the time to the first thrombosis or to revision revealed an average of 18 weeks for the DIAS TAT group and 56 weeks for the control group. The length of time to th rombosis or revision was significantly longer in the control group (P = 0.0058). Comparison of the number of weeks of function and serviceab ility of the grafts revealed the average DIASTAT graft functioned for 34 weeks and that of the control group for an average of 70 weeks (P = 0.0131). Comparison of the two groups showed a significant increase i n early thrombotic events (<90 days) in the DIASTAT grafts (P = 0.0013 ). CONCLUSIONS: The DIASTAT vascular access graft does not appear to b e the ideal hemodialysis access graft.