UTILIZATION OF EARLY FUNCTION VASCULAR PR OSTHESIS (DIASTAT(R) TYPE) IN HEMODIALYSIS

Diastat(R) ia a new expanded polytetrafluoroethylene vascular access g raft with a special cannulation segment. It has been suggested that th is graft reduces blood loss, time to hemostasis and the incidence of h ematomas and allows early use after its implantation. We analyze our e xperience with this graft after I year follow-up in patients with vasc ular problems and multiple previous vascular access failures. Seventee n Diastat(R) grafts have been implanted in 5 men ans 10 women (mean ag e: 62 +/- 2.6 (m +/- sem) years old: range 43-77 years). Fourteen vasc ular hemodialysis grafts were implanted in upper extremities and three in the lower limbs. Most patients had been requiring hemodialysis for many years (3.75 +/- 0.8 years; range 1-10 years). Hypertension, isch emic heart disease and peripheral vascular disease were present in 14. 4 and 9 patients respectively. All prosthetic vascular accesses were c annulated within 7 days of implantation (mean: 3.5 +/- 0.3 days; range : 1-7 days). Complications included four postoperative hematomas (23%) which did not delay first puncture. No found infections were observed . Nevertheless, a Staphylococcus aureus bacteremia was detected in I p atient, 1.5 months after surgery which resolved with antibiotic treatm ent. Three prosthetic thromboses (18%) were detected during the follow -up. One patient who developed a myocardial infarction, died one month after surgery. The cumulative patency rate at I year of follow-up was 81% (mean: 5.17 +/- 3.6 months; range: 7-12 months). In conclusion, D iastat(R) graft is a new synthetic graft which has shown an excellent graft survival in patients with vascular problems. Early puncture afte r implantation, with a minimal incidence of complications, is the main advantage of this graft.