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Complications in the Chronic Hemodialysis Patient

Joseph H. Merickel, MD; Robert C. Andersen, MD; Russell Knutson, MD; Martin L. Lipschultz, MD; Claude R. Hitchcock, MD, PhD

AMA Arch Surg. 1974;109(2):245-250.

Abstract
One hundred bovine carotid artery shunts were implanted for vascular access in chronic hemodialysis patients. Seventy-two percent of patients have continued to have functioning bovine artery shunts, but complications have required repeated attention. Forty-six percent of patients have bovine grafts functioning without problems, 26% have grafts functioning but with various problems, and 17% have had failure of the graft. Specific complications unique to this method of vascular access include infections at the "dialysis puncture" sites, hematomas and false aneurysms at these sites, edema of the arm, pseudodiaphragm formation at the venous anastomosis, and pseudointima formation with dissection. Despite these, the authors believe this method of arteriovenous shunt for chronic hemodialysis patients has definite indications and can be considered a positive adjunct in this new field of medicine and surgery.

Author Affiliations
From the Dialysis and Transplant Service, Hennepin County General Hospital, Minneapolis.

Footnotes
Accepted for publication April 3, 1974.

Read before the 31st annual meeting of the Central Surgical Association, Cincinnati, March 8, 1974.

Reprint requests to Department of Surgery, Hennepin County General Hospital, Minneapolis, MN 55415 (Dr. Hitchcock).

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