Vascular access for hemodialysis using bovine heterografts and polytetrafluoroethylene conduits

The University of Alberta's experience with the use of bovine and polytetrafluoroethylene (PTFE) grafts as renal dialysis conduits is reported. Over a 3 1/2-year period 100 patients had grafts placed. Most were placed in the forearm and a small number in the groin. Bovine grafts, while performing adequately as dialysis conduits, required multiple repairs to alleviate complications. The complications included thrombosis, stenoses at the graft-vein anastomosis and in the graft, aneurysm and infection. At the end of the study period 68% of the grafts were still functioning and 82% of the patients survived. The experience with PTFE grafts was less extensive. Analysis of the data indicates that there was a lower complication rate and that aneurysm formation and infection at puncture sites were rarely seen. Thrombosis secondary to stenosis at the graft-vein anastomosis was the most frequent complication. Graft and patient survival were nearly 90%. A comparison of bovine and PTFE grafts as replacement for failed bovine grafts showed that PTFE was much superior.