Use of a novel immediate access dialysis graft designed to prevent needle-related complications: A first-in-man case report.
Use of a novel immediate access dialysis graft designed to prevent needle-related complications: A first-in-man case report.
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DOI：
10.1177/1129729820917265
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
Ross JR
中科院分区：
文献类型：
--
作者：
Gage SM;Illig KA;Ross JR
目前，没有血管通路具有血液透析通路的所有理想品质，但特别缺乏的属性包括：易于识别（插管区）、易于进入、抗狭窄、耐重复插管、抗感染、抗急性针相关损伤和即时止血。这些属性的总体价值可以通过减少并发症（患者负担和痛苦，这也可能导致医疗保健成本增加）以及提高安全性和耐用性来实现。在本病例报告中，我们介绍了一种新型血液透析通路移植物，其有可能提供以下受益：其设计为自密封，植入后可立即使用，易于识别，易于进入，具有更耐用的插管区，并防止针相关损伤。本病例报告描述了首次在人体内使用这种新型移植物技术来替换巨大、血栓性和难以进入的动静脉瘘，为患者提供可能更安全和更持久的入路，无需放置桥接透析导管。这一单个患者的经验表明，这种新型移植物作为血液透析通路的植入和功能在患有终末期肾病的人类受试者中是可行的，并且它表明这种移植物的新特性（即，立即使用、易于识别、易于使用、插管区耐久性和防止针相关损伤）似乎按预期发挥作用。
Currently, there is no vascular access that possesses all ideal qualities for hemodialysis access, but attributes particularly lacking include: ease of identification (cannulation zone), ease of access, resistance to stenosis, durable to repetitive cannulation, resistance to infection, resistance to acute needle-related injuries, and instant hemostasis. The overall value of these attributes could be appreciated in the reduction of complications (patient burden and suffering, which can also result in increased healthcare costs), and improved safety and durability. In this case report, we present a novel hemodialysis access graft that has the potential to provide the following benefits: it is designed to be self-sealing and immediately usable post implant, easy to identify, easy to access, has more durable cannulation zones, and protects from needle-related injuries. This case report describes the first-in-man use of this novel graft technology to replace a giant, thrombotic, and difficult-to-access arteriovenous fistula to provide the patient with a potentially safer and more durable access that does not require placement of a bridging dialysis catheter. This single-patient experience suggests that implantation and function of this novel graft as a hemodialysis access is feasible in a human subject with end-stage renal disease, and it suggests that the novel properties (i.e. immediate use, easy identification, easy use, cannulation zone durability, and protection from needle-related injuries) of this graft seem to function as intended.