title: Clinical analysis of hemodialysis vascular access: comparision of autogenous arterioveonus fistula & arteriovenous prosthetic graft.
abstract: BACKGROUND
  Mature autogenous arteriovenous fistulas have better long term patency and require fewer secondary interventions compared to arteriovenous prosthetic graft. Our Study evaluated vascular patency rates and incidence of interventions in autogenous arteriovenous fistulas and grafts.
  
  
  METHODS
  A total of 166 vascular access operations were performed in 153 patients between December 2002 and November 2009. Thirty seven caeses were excluded due to primary access failure and loss of follow-up. One group of 92 autogenous arterioveous fistulas and the other group of 37 arteriovenous prosthetic grafts were evaluated retrospectively. Primary and secondary patency rates were estimated using the Kaplan-Meier method.
  
  
  RESULTS
  The primary patency rate (84%, 67%, 51% vs. 51%, 22%, 9% at 1, 3, 5 year; p=0.0000) and secondary patency rate (96%, 88%, 68% vs. 88%, 65%, 16% at 1. 3, 5 year; p=0.0009) were better in autogenous fistula group than prosthetic graft group. Interventions to maintain secondary patency were required in 23% of the autogenous fistula group (average 0.06 procedures/patient/year) and 65% of prosthetic graft group (average 0.21 procedures/patient/year). So the autogenous fistula group had fewer intervention rate than prosthetic graft group (p=0.01) The risk factor of primary patency was diabetus combined with ischemic heart disease and the secondary patency's risk factor was age.
  
  
  CONCLUSIONS
  Autogenous arteriovenous fistulas showed better performance compared to prosthetic grafts in terms of primary & secondary patency and incidence of interventions.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, CHA Gumi Medical Center, CHA University, Korea.
authors.forename: Duk-Sil
authors.initials: DS
authors.lastname: Kim
authors.forename: Sung-Wan
authors.initials: SW
authors.lastname: Kim
authors.forename: Jun-Chul
authors.initials: JC
authors.lastname: Kim
authors.forename: Ji-Hyung
authors.initials: JH
authors.lastname: Cho
authors.forename: Joon-Hyuk
authors.initials: JH
authors.lastname: Kong
authors.forename: Chang-Ryul
authors.initials: CR
authors.lastname: Park