[Progressive complications associated with the use of a bovine heterograft for vascular access].

Three bovine carotid heterografts, used for vascular access, were analysed after removal following the development of aneurysms in two cases and thrombosis in one. The first prosthesis was implanted in a 17-year-old man who suffered from myasthenia gravis and was undergoing plasmapheresis. It became notably dilated several months after implantation, and resection was necessary 14 months after insertion. The second graft was placed in a 31-year-old woman being treated for a severe chronic potassium insufficiency. It was removed 16 months after insertion because of thrombosis. The third bovine carotid heterograft was inserted in a 48-year-old patient on long-term hemodialysis and was removed 3.5 months later because of aneurysmal dilatation adjacent to the arterial anastomosis. These evolutionary and degenerative changes associated with the bovine carotid heterograft illustrate the limitations of this material as an interpositional limb for arteriovenous fistulas in angioaccess therapy. Small weaknesses have sometimes been noted in the microstructure of the graft material studied before implantation.