Initial experience with the Gore® Acuseal graft for prosthetic vascular access

Purpose: The purpose of this study is to report the short-term results of the Gore (R) Acuseal graft for prosthetic vascular access (pVA) in patients with end-stage renal disease on hemodialysis. Methods: Between October 2011 and October 2013, all the consecutive patients who underwent implantation of a new expanded Polytetrafluoroethylene (ePTFE) tri-layer graft were included in the study. Primary and secondary patency rate, time to first cannulation, and complications were recorded. Follow-up was performed at 1, 3, 6, and 12 months after the intervention. Results: Thirty ePTFE tri-layer heparin bonded grafts were implanted in 18 males and 12 females. The graft configuration was radial-basilic (n=12, 40%), brachial-basilic (n=10, 33.3%), femoro-femoral (n=3, 10.0%), radial-cephalic (n=2, 6.7%), radial-antecubital forearm (n=2, 6.7%), and brachial-axillary (n= 1, 3.3%). No patient was lost during a mean follow-up time of 6.3 +/- 5.9 months (range, 1-24; median, 5). Mean time to first cannulation was 2.4 +/- 1.2 days (range, 1-15). Primary functional patency rate was 68.0% +/- 10 at 6 and 12 months. Secondary patency rate was 93.3% +/- 6 at 6 and 12 months. Pseudoaneurysm, bleeding, seroma, or graft infection was never observed. Conclusions: In our experience, the Gore (R) Acuseal graft was useful and safe. Early cannulation was always performed, and structural complications did not occur. Primary functional and secondary patency rate are satisfactory in the short term.