Use of Heparin-Bonded Expanded Polytetrafluoroethylene Grafts for Renal Artery Reconstruction

Ann Vasc Surg. 2021 Jul:74:287-293. doi: 10.1016/j.avsg.2020.12.037. Epub 2021 Feb 4.

Abstract

Background: The purpose of this study was to analyze our initial experience in renal artery reconstruction with heparin-bonded expanded polytetrafluoroethylene (ePTFE) grafts.

Methods: The authors retrospectively reviewed the data of consecutive patients who received open renal reconstruction with a heparin-bonded ePTFE graft at our institution between January 2014 and December 2019.

Results: A total of 22 renal reconstructions with a heparin-bonded ePTFE graft were performed in 17 consecutive patients. In all cases, renal reconstruction was a concomitant procedure during surgical or endovascular aortic procedures. Postoperative complications within 30 days were observed in 9 (53%) patients, including acute kidney injury (n = 6), pneumonia (n = 1), retrograde type B aortic dissection (n = 1), and lower limb ischemia (n = 1). The 30-day mortality rate was 0%. In a median follow-up period of 32 (19-39) months, all grafts were patent without re-intervention. Six patients with preoperative stage 2 chronic kidney disease progressed to stage 3 during follow-up. No patient required temporary or permanent hemodialysis. One patient died from intestinal ischemia at 23 months after surgery.

Conclusions: This study showed that the patency after open renal reconstruction with a heparin-bonded ePTFE graft was excellent, with acceptable renal outcomes, and demonstrates its safety as a concomitant procedure during an aortic procedure. Heparin-bonded ePTFE grafts are a feasible and effective choice for open renal reconstruction in contemporary practice.

Keywords: Abdominal aortic aneurysm; Heparin-bonded expanded polytetrafluoroethylene graft; Renal artery reconstruction; Renal function.

MeSH terms

  • Aged
  • Anticoagulants / administration & dosage*
  • Anticoagulants / adverse effects
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / physiopathology
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / physiopathology
  • Aortic Aneurysm, Thoracic / surgery*
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Coated Materials, Biocompatible*
  • Female
  • Heparin / administration & dosage*
  • Heparin / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / instrumentation*
  • Polytetrafluoroethylene*
  • Postoperative Complications / etiology
  • Prosthesis Design
  • Renal Artery / diagnostic imaging
  • Renal Artery / physiopathology
  • Renal Artery / surgery*
  • Renal Artery Obstruction / diagnostic imaging
  • Renal Artery Obstruction / physiopathology
  • Renal Artery Obstruction / surgery*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Vascular Patency

Substances

  • Anticoagulants
  • Coated Materials, Biocompatible
  • Polytetrafluoroethylene
  • Heparin