The following information was reported to gore: on (b)(6) 2021, the patient was implanted with a gore® acuseal vascular graft as an av shunt for hemodialysis.Acuseal was implanted in the radial artery-ulnar brachial vein as a straight shape.On (b)(6) 2021, an increase in venous pressure was observed.As a treatment, pta (percutaneous transluminal angioplasty) was performed.Angiography showed a stenosis at the graft outflow tract.During the intervention, a contrast defect (suspected graft delamination) was observed in the graft.The suspected delamination site was located at the puncture site of the dialysis and the potential delamination was about 2-3 cm in length.Ballooning was performed and the reintervention was completed.On (b)(6) 2021, the patient's venous pressure was still high and shunt sound could not be confirmed.Reintervention was performed and the graft intima was removed with a fogarty catheter to treat the suspected delamination.Aside from removal of the intima, the entire original graft remains in the patient.It was confirmed that the shunt sound was improved.The patient tolerated the procedure.
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