Oakes D D, Spees E K, Light J A, Flye M W
Ann Surg. 1978 Apr;187(4):423-9. doi: 10.1097/00000658-197804000-00014.
Between January 1974 and December 1976 28 arteriovenous fistulae were created in 25 uremic patients using modified bovine arterial heterografts. Bovine grafts were inserted only if the patient's own vessels were deemed inadequate to permit the development of a useable Brescia fistula. Graft patency by the life-table method was 92% at three months and 75% at one year. Complications leading to graft failure included late thrombosis, inadequate healing of skin flaps, and graft disruption secondary to faulty cannulation. Ten patients died; none of the deaths were graft-related. At the end of the period of observation all patients requiring hemodialysis had functioning bovine grafts. It is felt that for this purpose the modified bovine arterial heterograft is superior to any other currently available vascular conduit. The location of these grafts should be planned so as to make maximal use of distal vasculature and allow multiple sequential access procedures in the same extremity. An idealized approach which encompasses these principles is presented.
1974年1月至1976年12月期间，使用改良的牛动脉异种移植物为25例尿毒症患者建立了28个动静脉内瘘。仅当认为患者自身血管不足以形成可用的布雷西亚内瘘时才植入牛移植物。采用寿命表法计算，移植物3个月时的通畅率为92%，1年时为75%。导致移植物失败的并发症包括晚期血栓形成、皮瓣愈合不良以及插管失误继发的移植物破裂。10例患者死亡，均与移植物无关。在观察期结束时，所有需要血液透析的患者的牛移植物均功能良好。认为为此目的，改良的牛动脉异种移植物优于目前任何其他可用的血管导管。应规划这些移植物的位置，以便最大程度地利用远端血管，并允许在同一肢体进行多次连续的通路操作。本文提出了一种包含这些原则的理想方法。
