Follow-up of polytetrafluoroethylene arteriovenous fistulae for haemodialysis.
The polytetrafluoroethylene (PTFE) arteriovenous fistula allows vascular access for haemodialysis where a primary fistula or brachio-basilic vein transposition is not possible. We report patency rates and complications associated with these prosthetic grafts. Fifty-nine upper limb PTFE grafts in 48 patients were evaluated with a mean follow-up of 19 months (range 2-54 months). Three grafts (5%) were never used. The primary patency rate at 6 weeks was 90%. Cumulative secondary patency rates were 66% at 6 months, 36% at 12 months, 17% at 18 months, 3% at 24 months and 2% at 30 months. None of the grafts had remained patent at 3 years. Forty-six percent of the grafts studied thrombosed at least once and 32% became infected. Although the initial primary patency rate achieved compares favourably with that reported for brachio-basilic transposition fistulae, this study confirms that the use of prosthetic material is associated with a poor overall patency rate and high risk of complications. All options using autologous vein should be exhausted before considering prosthetic material.
Modarai
B
B
Department of Urology, Guy's and St. Thomas' Hospitals, Thomas Guy House, London, UK.
Dasgupta
P
P
Taylor
J
J
Koffman
G
G
Khan
M S
MS
D000293:Adolescent; D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000295:instrumentation*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D002408:Catheters, Indwelling; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D006435:Renal Dialysis / Q000379:methods*; D016896:Treatment Outcome
D011138:Polytetrafluoroethylene