A new choice for vascular access: Spiral Flow AV Graft

Cetingok U
Department of Cardiovascular Surgery, Kavaklidere Umut Hospital, Ankara, Turkey
In Abstracts from VAS 8th International Congress, April 25-27, 2013 Prague, Czech Republic. J Vasc Access 2013; 14(1): 36-37

Background

The most commonly used grafts for vascular access are the polytetraflouroethylene (PTFE) grafts. Different types of PTFE grafts are used in the vascular access applications for a long time. Neointimal hyperplasia at the distal anastomosis is one of the primary failure modes for prosthetic grafts resulting in occlusion and loss of function. The Spiral Flow Vascular Access Graft is a wrapped, expanded polytetrafluoroethylene (ePTFE) graft with custom features injection moulded of Chronoflex polyurethane.

The distal portion of the graft contains the patented Spiral Flow™ Inducer, the Inducer Indicator Ring and pre-cut distal anastomotic cuff. The injection moulded components of the graft are non-removable.

Materials and Methods

From July 2010 until January 2013, Spiral Laminar Flow PTFE Graft (Vascular Flow Technologies Ltd., UK) was implanted in 16 patients for vascular access. Primary graft implantation was performed in 2 patients.

Results

Mean follow-up was 26 months. The complications as graft infection, pseudoaneurysm, venous hypertension was not seen and thrombectomy was performed two patients due to graft thrombosis. Primary patency rate was 88% and secondary patency rate was 100% during follow-up.

Conclusions

The process of blockage caused by neointimal hyperplasia in and near the graft-vein anastomosis is driven to a large part by disturbed or turbulent flow. The Spiral Flow™ Vascular Access Graft delivering less turbulent energy by utilizing Spiral Laminar Flow™ delivering blood flow into the venous system like a native AV fistula should: Improve device patency, prolong the effective life of devices, reduce downstream disease progression, improve patient quality of life.This flow pattern can be determined with color doppler ultrasound study using a transverse interrogation of the vessel at low velocity settings. The “red/blue split” seen in transverse color doppler ultrasound study is characteristic of spiral laminar flow and is usually seen in healthy arteries. The goal of this study is to determine if the SLF™ Graft creates spiral laminar flow and if that might contribute to improved patency.