Use of bovine carotid artery for buttonhole technique hemodialysis

Abstract

Purpose: Assess the feasibility of using a bovine carotid artery graft for buttonhole technique hemodialysis in patients who are not candidates for a native fistula. Methods: Case reports used to demonstrate selection criteria and results for this approach. Criteria include: knowledgeable patient with prior dialysis experience, stable graft in place for 3 months minimum, not a candidate for a native fistula, and able to maintain close follow-up. Results: Both grafts were based on axillary vessels and have been in place for a total of 64 months. They have been used for dialysis via buttonhole for a total of 40 months. There have been three procedures on these patients, post-buttonhole use (.87/year). There have been no infections. Conclusions: These patients were carefully selected based on desire, support, knowledge/experience and ability. Their success suggests that buttonhole technique for hemodialysis on a synthetic semi-biologic graft can be accomplished with morbidity and longevity similar to any graft using non-buttonhole needle access.