Patency and flow characteristics using stapled vascular anastomoses in dialysis grafts

Background: Improving patency of hemodialysis grafts is challenging. Vascul ar stapling creates nonpenetrating anastomoses. possibly decreasing intimal hyperplasia. We investigated patency and flow characteristics of stapled h emodialysis grafts. Methods: Eighty-six grafts (41 stapled, 45 sewn) were placed in 84 patients (prospective, randomized). The groups had comparable demographics. Results: Thirty-six grafts were functioning at the study endpoint. Complica tions in both groups were similar. The primary patency (stapled, 342 days v ersus sewn, 382 days; P = 0.67) and secondary patency (stapled, 513 days ve rsus sewn, 507 days; P = 0.76) had no significant differences. Flow charact eristics were similar between the groups. Thrombectomies per patient-year w ere 1.01 for stapled grafts and 1.12 for sewn grafts (not significant). Sta pling decreased the average operating time by 4.5 minutes. Conclusions: Stapled and sewn anastomoses have similar primary and secondar y patency and flow characteristics, with minimal operative time differences . Stapled anastomoses are safe but had no advantage over sewn anastomoses i n this study. (C) 2001 Excerpta Medics, Inc. All rights reserved.