Intimal hyperplasia develops preferentially in regions where the blood flow is stagnant and wall shear stress low. The small amplitude helical geometry of the SwirlGraft was designed to ensure physiological-type swirling flow, and thus suppress the triggers. We report the first conceptual testing of the SwirlGraft. Primary, assisted primary and secondary patency rates at 6 months in 20 patients were 57.9+/-11.4%, 84.4+/-8.3% and 100+/-0.0%. There was angiographic evidence of reduction of helical geometry in a proportion of the grafts. The helical graft is associated with high assisted primary and secondary patency. Elaboration of the surgical implantation techniques and an improved SwirlGraft design can be expected to exploit the advantages of the helical concept.
A larger AAA size is independently associated with an increased incidence of perioperative cardiovascular complications after elective infrarenal AAA repair.
Hydrostatic pressure combined with warmth generates the greatest venous distensibility in the lower arm in haemodialysis patients in a sitting position and is not significantly different compared to healthy volunteers. Without the superior provocation method, venous diameters of haemodialysis patients can be assessed as false-negatives yielding that a primary radio cephalic arteriovenous fistula (RCAVF) at wrist level (the first choice) in these patients will be withheld.
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