TY - JOUR
T1 - Comparison of Gianturco Z Stents and Wallstents in a Hemodialysis Access Graft Animal Model
AU - Trerotola, Scott O.
AU - Fair, Jeffrey H.
AU - Davidson, Darrell
AU - Samphilipo, Michael A.
AU - Magee, Carolyn A.
N1 - Funding Information:
' From the Russell H. Morgan Department of Radiology and Radiological Science (S.O.T., M.A.S., C.A.M.) and the Depart-merit of Surgery ( J.H,F,), Johns Hopkins Medical Institutions, Baltimore, ~ dan,d the Department of Pathology, Indiana UniversityMedicalCenter, Indianapolis (D.D.). From the 1993 SCVIR annual meeting. Received July 8, 1994; revision requested September 15; revision received October 11; accepted October 17. SUPported in part by the William Mayo Gatewood Fund. re- print requests to S.O.T., Department of Radiology, Indiana University Medical Center, University Hospital 0279,550 N University Blvd, Indianapolis, IN 46202-5253.
Funding Information:
Acknowledgments: The authors gratefully acknowledge the support of the William Mayo Gatewood Fellowship Fund of the Johns Hopkins Hospital Department of Radiology; the support of Schneider USA, Cook Incorporated, and WL Gore and Associates; and the superb work of Luke Brennecke, DVM, of Pathology Associates. In addition, we thank Connie Deghani and Sherrie Leucht for their tireless secretarial support, and Andrew Zhou, PhD, for assistance with statistical analysis.
PY - 1995/5
Y1 - 1995/5
N2 - Purpose: To compare the primary patency of two structurally different metallic stents in an animal model of hemodialysis access grafts. Materials and Methods: Nineteen synthetic femorofemoral arteriovenous shunts were created in 10 dogs. After a 1-month period of maturation (during which one graft thrombosed), stents were placed spanning the venous anastomosis. The grafts were divided into two treatment groups (Wallstent, n = 6, and Gianturco stent, n = 6) and a control group with no stent (n = 6). Fistulograms and pressure measurements were obtained at monthly intervals for 6 months or until thrombosis of the graft. Results: Mean graft patency in the Wallstent group (112 days ± 30) was significantly shorter than in the control (157 days ± 32, P < .03) or Gianturco (157 days ± 32, P < .05) groups. Patency in the Gianturco stent group was no different from that in the control group. Stenosis due to intimal hyperplasia within the stents appeared greater in the Wallstent group but did not achieve statistical significance. One Wallstent migration, three Gianturco stent shifts, and two Gianturco stent breakages occurred. Histologic examination revealed a necrotizing vasculitis in the portion of vein containing the stent in all grafts treated with the Gianturco stent but not in any other grafts. Conclusion: In an animal model of hemodialysis access grafts, the Gianturco stent had longer primary patency than the Wallstent when placed across the venous anastomosis. However, stent fractures and focal necrotizing inflammation may limit the use of the Gianturco stent in hemodialysis access.
AB - Purpose: To compare the primary patency of two structurally different metallic stents in an animal model of hemodialysis access grafts. Materials and Methods: Nineteen synthetic femorofemoral arteriovenous shunts were created in 10 dogs. After a 1-month period of maturation (during which one graft thrombosed), stents were placed spanning the venous anastomosis. The grafts were divided into two treatment groups (Wallstent, n = 6, and Gianturco stent, n = 6) and a control group with no stent (n = 6). Fistulograms and pressure measurements were obtained at monthly intervals for 6 months or until thrombosis of the graft. Results: Mean graft patency in the Wallstent group (112 days ± 30) was significantly shorter than in the control (157 days ± 32, P < .03) or Gianturco (157 days ± 32, P < .05) groups. Patency in the Gianturco stent group was no different from that in the control group. Stenosis due to intimal hyperplasia within the stents appeared greater in the Wallstent group but did not achieve statistical significance. One Wallstent migration, three Gianturco stent shifts, and two Gianturco stent breakages occurred. Histologic examination revealed a necrotizing vasculitis in the portion of vein containing the stent in all grafts treated with the Gianturco stent but not in any other grafts. Conclusion: In an animal model of hemodialysis access grafts, the Gianturco stent had longer primary patency than the Wallstent when placed across the venous anastomosis. However, stent fractures and focal necrotizing inflammation may limit the use of the Gianturco stent in hemodialysis access.
KW - Dialysis, shunts, 91.494
KW - Veins, grafts and prostheses, 91.494
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U2 - 10.1016/S1051-0443(95)72828-7
DO - 10.1016/S1051-0443(95)72828-7
M3 - Article
C2 - 7647440
AN - SCOPUS:0029303282
VL - 6
SP - 387
EP - 396
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
SN - 1051-0443
IS - 3
ER -