• Journal of Chest Surgery
• /
• v.29 no.8
• /
• pp.883-888
• /
• 1996

Expanded polytertrafluoroethylene (expanded PTFE) graft fistulas are widely used as secondary vascu- lar access for patients receiving long-term hemodialysis treatment. We implanted 48 grafts in )5 patients during the period from August 1990 to August 1995. Forty-three grafts in 32 patients were followed for 1 to 46 months. We performed forearm straight grafts in 36 grafts and upperarm straight grafts in 7 grafts. We experienced 3 operative failures, 22 early and late complications(15 graft thrombosis). Cumulative patency for all grafts at 12 months was 63%, at 24 months 32%, at 36 months 32% Forearm graft survival at 12 months was 55%, at 24 months 30%, at )6 months 30%. Upperarm graft survival at 12 months was 8)oyo and 24 months 41%. After reviewing our experience, we think that expanded-PTFE grart as secondary vascular access still have many complications and low survival than autogenous a teriovenous fistula. And so utilization of the expanded PTFE fistula requires better techniques, close observation and maintenance to keep it functional.

• Journal of Chest Surgery
• /
• v.9 no.1
• /
• pp.10-19
• /
• 1976

One hundred and seventy-four patients were treated in this Department since 1956. One hundred and fifteen patients of them were surgically treated. They were classified on the basis of the disease entity as follows; 48 case of thrombo-angiitis obliterance, 8 cases of Leriche syndrome, 12 cases of arterial embolism, 36 arterial aneurysm, 5 arterio-venous fistula, 15 arterial and venous injuries, 8 pulseless diseases, 2 coarctation of aortas, 15 varicose veins, 12 thrombophlebitis, 9 superior venacaval syndromes, 2 inferior vena caval obstructions and Raynaud's diseases. All the cases of the Burger's diseases were males, and half of them were in the fourth decades, 39 cases underwent undergone unilateral or bilateral sympathectomies. All the Leriche syndromes were males aged over fifty. Three cases out of six were suffering from diabetes mellitus. 2 cases underwent aorto-femoral bypass graft with Y-shaped dacrons. And two embolectomies were performed in 2 cases. Eight cases of arterial embolisms among 12 had mitral valvular diseases with auricular fibrillation The most common site of lodgement of emboli was femoral artery. Nine out of 14 underwent embolectomies with Fogarty catheters. There were 14 peripheral arterial aneurysms, 16 thoracic and/or abdominal aortic aneurysms, and 4 dissecting aneurysms. Most frequent cause of peripheral arterial aneurysms were external trauma. Thoracic and abdominal aortic aneurysms were non-traumatic. And four cases of the dissecting aneurysms had significant hypertension and aged over fifty. Among 5 cases of arteriovenous fistulas, 2 cases hand typical Branham's sign, and they were normalized after operation. Eight cases of pulseless disease were females and aged from three to twenty-five. Three out of them were treated surgically using dacron prosthetic grafts, but the results of the surgery were variable and not satisfactory. A case of coarctation of aorta was treated surgically with an excellent result. Fourteen out of 15 varicose veins underwent ligation of the saphenous vein system, exstirpation of the varicose veins, stripping or some combination of these methods. Two cases of superior vena caval syndromes were operated by bypass graft between the left innominate vein and the right auricle. Two cases of inferior vena caval obstructions were operated upon through right atrial route using extracorporial circulation. All the four cases of vena caval obstructions showed excellent results postoperatively. Two cases out of 12 thrombophlebitis underwent thrombectomies. One of two Raynaud's diseases was surgically treated with an excellent result.