Patency rates and complications of Exxcel yarn-wrapped polytetrafluoroethylene grafts versus Gore-tex stretch polytetrafluoroethylene grafts: a prospective study.
OBJECTIVE
Polytetrafluoroethylene (PTFE) has long been used for hemodialysis access when there is no suitable superficial vein. We conducted a prospective randomized study to compare two PTFE grafts; the stretch Gore-tex graft and the Exxcel graft.


METHODS
Between May 2000 and February 2001, PTFE grafts were implanted for hemodialysis access in the upper extremities of 94 consecutive patients with end-stage renal disease. Graft selection was randomized, with patients receiving either a Gore-tex or an Exxcel graft. All grafts were monitored for signs of thrombosis or other complications. Graft survival was analyzed using a life-table analysis and the log-rank test was applied to compare graft patency.


RESULTS
The primary patency rates 1 and 2 years after implantation were 51% and 36% for the Exxcel grafts, and 71% and 45% for the Gore-tex grafts, respectively. The difference between the two groups was not significant at any time. The incidence of complications needing further surgical management was 8.2% in the Exxcel group and 6.7% in the Gore-tex group, without a significant difference.


CONCLUSIONS
Exxcel grafts or Gore-tex stretch grafts can be used for dialysis access with similar expected outcomes for up to 2 years, despite the differences in their outer surface design. The yarn-wrapped design does not appear to enhance the graft patency and we found no remarkable difference.
Ko
Po-Jen
PJ
Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu Shing Street, Kweishan, Taoyuan 333, Taiwan.
Hsieh
Hung-Chang
HC
Chu
Jaw-Ji
JJ
Lin
Pyng Jing
PJ
Liu
Yun-Hen
YH
D001166:Arteriovenous Shunt, Surgical; D001672:Biocompatible Materials; D001807:Blood Vessel Prosthesis; D005260:Female; D006083:Graft Occlusion, Vascular; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000009:adverse effects; D011446:Prospective Studies; D011474:Prosthesis Design; D006435:Renal Dialysis / Q000295:instrumentation*; D014654:Vascular Patency
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene