Thoratec Vectra Manual Del Usuario página 8

Figure 7. Insertion of fully assembled tunneler
4. With the tip of the tunneler exposed, the tip is removed and the rod is pulled away,
leaving the sheath in place subcutaneously.
5. Place the extra sheath over the rod and thread the tunneler tip onto the end of the
tunneler rod to hold the sheath in place.
6. Repeat steps 3 and 4 for the remaining leg of the loop.
7. Insert the Vectra VAG into one side of the subcutaneously placed sheath and gently
push the graft through while using a rotating motion if necessary, while irrigating
liberally with sterile saline.
Do NOT pull the graft through the tunneler sheath. Do NOT twist the graft.
8. Leaving the first sheath cited in step 7 in place, insert the Vectra VAG into the
other subcutaneously placed sheath and gently push the graft through while irri-
gating liberally. (Figure 8)
Figure 8. Insert graft into lubricated sheath
9. Position the graft to make sure the loop portion is smooth and does not kink and
that the more densely reinforced portion (as shown in figure 4) of the graft is at the
loop apex. (Figure 9)
Note: Due to the compliant nature of the Vectra, it will expand slightly once
exposed to normal arterial pressure. Therefore, to avoid kinking after pressuriza-
tion, it is recommended that extra space of approximately 2cm be created in the
subcutaneous pocket around the apex of the looped portion of the graft. Once the
graft is pressurized, this will allow for free expansion of the graft.
Figure 9. Positioning graft apex
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Vectra Vascular Access Graft