Biomaterial Database

Massaging thrombosed PTFE hemodialysis access graft - recipe for disaster. 2007

B M Shrestha

Sheffield Kidney Institute, Northern General Hospital, Sheffield, UK. shresthabm@doctors.net.uk

Early thrombosis of a polytetrafluoroethylene (PTFE) graft used for hemodialysis vascular access can result from technical error or hypotension and hypovolaemia in the immediate postoperative period. Massaging a graft to dislodge a freshly formed thrombus with a view to restoring blood flow can lead to acute limb ischaemia from embolisation of the artery as a result of migration of the thrombus from the arterial end of the graft, hence massaging of thrombosed grafts should be avoided. This report describes the management of a 35-year-old diabetic male who developed acute ischaemia of hand due to embolisation of the radial artery following massage of a thrombosed brachio-basilic forearm PTFE loop graft.

UI	MeSH Term	Description	Entries
D007511	Ischemia	A hypoperfusion of the BLOOD through an organ or tissue caused by a PATHOLOGIC CONSTRICTION or obstruction of its BLOOD VESSELS, or an absence of BLOOD CIRCULATION.	Ischemias
D007676	Kidney Failure, Chronic	The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION.	ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D008297	Male		Males
D008405	Massage	The systematic and methodical manipulations of body tissues best performed with the hands for the purpose of affecting the nervous and muscular systems and the general circulation.	Zone Therapy,Massage Therapy,Therapy, Zone,Massage Therapies,Therapies, Massage,Therapies, Zone,Therapy, Massage,Zone Therapies
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D011138	Polytetrafluoroethylene	Homopolymer of tetrafluoroethylene. Nonflammable, tough, inert plastic tubing or sheeting; used to line vessels, insulate, protect or lubricate apparatus; also as filter, coating for surgical implants or as prosthetic material. Synonyms: Fluoroflex; Fluoroplast; Ftoroplast; Halon; Polyfene; PTFE; Tetron.	FEP,Fluon,Politef,Polytef,TFE,Teflon,Expanded PTFE,Fluoroplast,GORE-TEX,Goretex,PTFE,Tarflen,GORE TEX,PTFE, Expanded
D011474	Prosthesis Design	The plan and delineation of prostheses in general or a specific prosthesis.	Design, Prosthesis,Designs, Prosthesis,Prosthesis Designs
D001807	Blood Vessel Prosthesis	Device constructed of either synthetic or biological material that is used for the repair of injured or diseased blood vessels.	Vascular Prosthesis,Blood Vessel Prostheses,Tissue-Engineered Vascular Graft,Graft, Tissue-Engineered Vascular,Grafts, Tissue-Engineered Vascular,Prostheses, Blood Vessel,Prostheses, Vascular,Prosthesis, Blood Vessel,Prosthesis, Vascular,Tissue Engineered Vascular Graft,Tissue-Engineered Vascular Grafts,Vascular Graft, Tissue-Engineered,Vascular Grafts, Tissue-Engineered,Vascular Prostheses,Vessel Prostheses, Blood,Vessel Prosthesis, Blood
D004617	Embolism	Blocking of a blood vessel by an embolus which can be a blood clot or other undissolved material in the blood stream.	Embolus,Embolisms
D005542	Forearm	Part of the upper extremity in humans and primates extending from the ELBOW to the WRIST.	Antebrachium,Antebrachiums,Forearms