Heparin bonded hemodialysis e-PTFE grafts result in 20% clot free survival benefit

J Vasc Access. Jul-Sep 2009;10(3):153-6. doi: 10.1177/112972980901000303.

Abstract

Luminal surface heparin bonded hemodialysis e-PTFE grafts (N=83) with prolonged bioactivity retention (CBAS technology) were compared to 67 control e-PTFE grafts using Kaplan-Meier survival curve estimates. Log-rank tests were used for statistical comparisons between groups. Heparin bonded graft recipients were on average 3.5 years older (NS), and had upper arm grafts in 66% vs. 43% (p=0.003) compared to controls. There was no clot-free survival (CFS) difference between groups for upper arm vs. forearm placed grafts (p=0.792). Patient mortality at one year was 15%, with no group difference. The overall combined clot-free survival for all 150 e-PTFE grafts was 69% at 12 months. At 6 and 12 months, CFS for the heparin bonded graft group was 88% and 78%, which is significantly higher than that of 69% and 58% for the control group, respectively, (p=0.007). It is concluded that heparin binding technology to artificial surfaces has evolved to a clinically powerful technique for the hemodialysis patient resulting in a 20% improved primary graft patency of about 80% at one year.

MeSH terms

  • Anticoagulants / administration & dosage*
  • Arteriovenous Shunt, Surgical / adverse effects
  • Arteriovenous Shunt, Surgical / instrumentation*
  • Arteriovenous Shunt, Surgical / mortality
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis Implantation / mortality
  • Blood Vessel Prosthesis*
  • Case-Control Studies
  • Coated Materials, Biocompatible*
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / physiopathology
  • Graft Occlusion, Vascular / prevention & control*
  • Heparin / administration & dosage*
  • Humans
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / therapy
  • Polytetrafluoroethylene*
  • Prosthesis Design
  • Renal Dialysis* / adverse effects
  • Renal Dialysis* / mortality
  • Thrombosis / etiology
  • Thrombosis / physiopathology
  • Thrombosis / prevention & control*
  • Time Factors
  • Treatment Outcome
  • Vascular Patency

Substances

  • Anticoagulants
  • Coated Materials, Biocompatible
  • Polytetrafluoroethylene
  • Heparin