title: Long-term patency of autogenous saphenous veins vs. PTFE interposition graft for prosthetic hemodialysis access.
abstract: OBJECTIVE
  Prosthetic vascular access is the other choice when the superficial venous system is inadequate to perform a simple radio-cephalic and brachio-cephalic fistula.
  
  
  METHODS
  This paper reports the outcomes of a prospective cohort study of 54 patients who underwent either saphenous vein (SVI Group, n=29) or PTFE graft (PTFE Group, n=25) interposition surgery for prosthetic hemodialysis access. All patients were evaluated via color Doppler ultrasonography during preoperative course and superficial venous systems of these patients were found inadequate to perform simple radial/brachial artery-cephalic vein anastomosis. Follow-up was performed for every 6-months period. Kaplan-Meier analysis and Log Rank test was used for estimation and comparison of the patency.
  
  
  RESULTS
  In SVI group access failure was observed in 5 of 29 patients (17.2%). In PTFE group, access failure was observed in 13 of the 25 patients (52%). Primary patency rate was 93% in 12th month and 82% in 24th month in SVI group while it was 88% in 12th month and 56% in 24th month in PTFE group. According to the Kaplan-Meier method, mean time of primary patency was significantly higher in SVI group when compared to PTFE group (33.03±1.32 months vs. 28.16±1.91 months, Log Rank chi-square value: 7.01, df:1, p=0.008). Secondary patency rate was 96% in 12th month and 93% in 24th month for SVI group while 96% in 12th month and 84% in 24th month for PTFE group. According to the Kaplan-Meier method, mean time of secondary patency was significantly higher in SVI group when compared to PTFE group (34.27±0.95 months vs. 31.16±1.40 months, Log Rank chi-square value: 7.33, df:1, p=0.007).
  
  
  CONCLUSIONS
  Autologous saphenous vein can be preferably chosen as a prosthetic hemodialysis access graft due its higher primary and secondary patency, lower complication rate and cost when compared with PTFE grafts.
authors.affiliation: Clinic of Cardiovascular Surgery, Ankara Education and Research Hospital, Ankara-Turkey. ademilkay@gmail.com.
authors.forename: Alper
authors.initials: A
authors.lastname: Uzun
authors.forename: Adem Ilkay
authors.initials: AI
authors.lastname: Diken
authors.forename: Adnan
authors.initials: A
authors.lastname: Yalçinkaya
authors.forename: Onur
authors.initials: O
authors.lastname: Hanedan
authors.forename: Ömer Faruk
authors.initials: ÖF
authors.lastname: Ciçek
authors.forename: Gökhan
authors.initials: G
authors.lastname: Lafçi
authors.forename: Garip
authors.initials: G
authors.lastname: Altintaş
authors.forename: Kerim
authors.initials: K
authors.lastname: Cağli
mesh_terms: D001166:Arteriovenous Shunt, Surgical; D019917:Blood Vessel Prosthesis Implantation; D001916:Brachial Artery / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D005542:Forearm / Q000098:blood supply*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D006435:Renal Dialysis; D012501:Saphenous Vein / Q000502:physiology*; D018608:Ultrasonography, Doppler; D014654:Vascular Patency