Abstract
Recently, new synthetic absorbable cuff materials (D L-lactic-glycolie acid (80/20) copolymer) with the same composition as that of absorbable surgical suture have been developed in Japan. In experimental studies, we have found previously that this biodegradable material was suitable for use in venous anastomosis as a cuff material, the cuff layer being completely absorbed within 20 weeks after anastomosis in rats. In this study, one year later, there were no stenotic changes in the vascular lumen and the anastomosed site showed no evidence of infection. End-cephalic vein-to-end of radial artery fistula in wrist were created by the cuff method in 11 patients with end-stage renal disease. Only one patient showed venous maturation failure. Ten of 11 vascular accesses created were sufficiently available for hemodialysis, providing sufficient flow of more than 200 ml/min. According to the venous-fistulographic findings, the fistula diameter dilated gradually with time after A-V anastomosis, becoming more than 70% that of the proximal artery 20 weeks later. This finding suggested that this type of anastomosis using a cuff made of the present synthetic absorbable material has sufficient flexibility.
