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A case of dissection in an ACUSEAL-modified HeRO graft.
J Vasc Access 2019; :1129729819894465JV

Abstract

BACKGROUND

The use of the HeRO system with the early-access ACUSEAL graft avoids the need for a tunnelled dialysis catheter as a bridge for vascular access. Established complications of this system include thrombosis, graft infection, haematoma, and pseudoaneurysm formation.

CASE DESCRIPTION

A 72-year-old patient found to have a dissection flap at the venous cannulation point (ACUSEAL component) of a right arm HeRO graft. The ACUSEAL was replaced in theatre and subsequent duplex imaging confirmed satisfactory graft function.

CONCLUSION

This case demonstrates a serious yet previously undescribed complication of cannulation of an ACUSEAL graft. The trilaminar construction of the graft may increase the likelihood of disruption of the luminal layer during repeated needling and predispose it to dissection. Given the consequences of graft failure in such patients, urgent intervention is warranted when graft dissection is suspected.

Authors+Show Affiliations

Ninewells Hospital, Dundee, UK.Ninewells Hospital, Dundee, UK.Ninewells Hospital, Dundee, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31841080

Citation

Bradley, N A., et al. "A Case of Dissection in an ACUSEAL-modified HeRO Graft." The Journal of Vascular Access, 2019, p. 1129729819894465.
Bradley NA, Guthrie G, Suttie S. A case of dissection in an ACUSEAL-modified HeRO graft. J Vasc Access. 2019.
Bradley, N. A., Guthrie, G., & Suttie, S. (2019). A case of dissection in an ACUSEAL-modified HeRO graft. The Journal of Vascular Access, p. 1129729819894465. doi:10.1177/1129729819894465.
Bradley NA, Guthrie G, Suttie S. A Case of Dissection in an ACUSEAL-modified HeRO Graft. J Vasc Access. 2019 Dec 16;1129729819894465. PubMed PMID: 31841080.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A case of dissection in an ACUSEAL-modified HeRO graft. AU - Bradley,N A, AU - Guthrie,G, AU - Suttie,S, Y1 - 2019/12/16/ PY - 2019/12/17/entrez KW - ACUSEAL KW - HeRO graft KW - dialysis access KW - early-access haemodialysis graft KW - prosthetic grafts SP - 1129729819894465 EP - 1129729819894465 JF - The journal of vascular access JO - J Vasc Access N2 - BACKGROUND: The use of the HeRO system with the early-access ACUSEAL graft avoids the need for a tunnelled dialysis catheter as a bridge for vascular access. Established complications of this system include thrombosis, graft infection, haematoma, and pseudoaneurysm formation. CASE DESCRIPTION: A 72-year-old patient found to have a dissection flap at the venous cannulation point (ACUSEAL component) of a right arm HeRO graft. The ACUSEAL was replaced in theatre and subsequent duplex imaging confirmed satisfactory graft function. CONCLUSION: This case demonstrates a serious yet previously undescribed complication of cannulation of an ACUSEAL graft. The trilaminar construction of the graft may increase the likelihood of disruption of the luminal layer during repeated needling and predispose it to dissection. Given the consequences of graft failure in such patients, urgent intervention is warranted when graft dissection is suspected. SN - 1724-6032 UR - https://www.unboundmedicine.com/medline/citation/31841080/A_case_of_dissection_in_an_ACUSEAL-modified_HeRO_graft L2 - http://journals.sagepub.com/doi/full/10.1177/1129729819894465?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -