Polytetrafluoroethylene and bovine grafts for vascular access in patients on long-term hemodialysis

A 4-year retrospective chart review of patients whose vascular access for hemodialysis was via a polytetrafluorethylene (PTFE) or a bovine graft revealed that cumulative patency differed little between the two groups. The average graft life was 27 months. Those with vascular access through the forearm, particularly with a loop type of graft, fared the best. Recurrent thrombosis was a serious problem. For this the authors recommend elective graft replacement followed by a "rest period" of 2 to 3 weeks. Failing grafts should be repaired as directed by fistulographic findings. Polytetrafluoroethylene seems to be safer, if not more reliable, than the bovine graft. Rupture and life-threatening hemorrhage did not occur with PtFE.