title: A polyurethane vascular access graft and a hybrid polytetrafluoroethylene graft as an arteriovenous fistula for hemodialysis: comparison with an expanded polytetrafluoroethylene graft.
abstract: OBJECTIVE
  We evaluated a polyurethane vascular access graft (TVAG), a hybrid polytetrafluoroethylene graft (hPTFEG), and an expanded polytetrafluoroethylene graft (ePTFEG) for postoperative complications and graft patency in their use as prosthetic devices of vascular access for hemodialysis.
  
  
  METHODS
  Between August 1993 and October 2001, we treated 200 patients in whom A-V fistulas were placed by the same surgeon. These were divided into the following four groups according to the type of blood access: 27 cases of ePTFEG, 23 cases of TVAG, 22 cases of hPTFEG, and 128 cases of an autogenous A-V fistula. We calculated the cumulative patency rates by the Kaplan-Meier method, including primary (problem-free) and secondary (revised or functional) patency rates.
  
  
  RESULTS
  The hPTFEG group experienced few thromboses. The absence of perigraft edema in the TVAG group permitted the early use of the TVAG within a few postoperative days for hemodialysis. Among the three graft groups, the primary patency was the best in the hPTFEG group (94.7% at 1 year and 86.1% at 2 years), with a significant difference versus the ePTFEG group. In regard to secondary patency, hPTFEG had an excellent patency of 100% at 1 year and 90.9% at 2 years, and TVAG had a comparable patency with that of ePTFEG.
  
  
  CONCLUSIONS
  The hPTFEG was considered superior to ePTFEG in terms of being complication-free and had the excellent 2 year secondary patency of 90.9%. TVAG, with a patency equal to that of ePTFEG, could be used immediately after implantation due to the absence of limb edema.
authors.affiliation: Department of Surgery, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan. hatiya@oka.urban.ne.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Matsuda
authors.forename: Masashi
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Oka
authors.forename: Atsunori
authors.initials: A
authors.lastname: Nakao
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Choda
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kokumai
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kunitomo
authors.forename: Noriaki
authors.initials: N
authors.lastname: Tanaka
mesh_terms: D001166:Arteriovenous Shunt, Surgical; D019917:Blood Vessel Prosthesis Implantation; D002408:Catheters, Indwelling; D005260:Female; D006801:Humans; D008297:Male; D011138:Polytetrafluoroethylene; D011140:Polyurethanes; D006435:Renal Dialysis / Q000295:instrumentation*; D012189:Retrospective Studies
chemical_list: D011140:Polyurethanes; D011138:Polytetrafluoroethylene