Vascular Flow Technology: Another run-of-the-mill graft or a breakthrough technology? Experience and perspective from a US centre
Patients and methods
From January, 2012 – February, 2013, 19 Spiral Flow™ AV Access Grafts (Vascular Flow Technologies Ltd) were placed in 18 patients. The mean age was 60 years (range 42-84 years); 37% (7) were male. Patients presented with the following comorbidities: six diabetes (32%); 17 hypertension (90%); five CAD (26%); four CHF (21%); five CVA (26%); six PVD (32%). Grafts were implanted as: 11 upper arm; two forearm; five femoral; and one chest wall.
The mean follow-up was six months. There are 11 grafts (58%) still in use. Three grafts (15%) were removed for infection; two grafts thrombosed (10%); two grafts were ligated for severe steal (10%). There were two grafts with seroma (10%), but they remained functional. There were three wound complications (15%) and three arm swelling (15%). One graft was ligated (5%). There were no pseudoaneurysms. Two patients died with functioning grafts.
Overall patency results are as follows:
|90% ± 9%||90% ± 9%||100% ± 0%|
The early results are encouraging and tend to be better compared to standard straight ePTFE and heparin bonded grafts. This might be explained on the basis of improved haemodynamics created by the spiral laminar flow.