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Long-term function of vascular access for hemodialysis
M A Enzler1, T Rajmon, M Lachat
1Department of Surgery, Zurich University Hospital, Switzerland.
Clinical Transplantation
|December 1, 1996
Summary
Autogenous arteriovenous fistulas (AVF) and interposition grafts show comparable patency for hemodialysis access, though women experienced lower rates. Sheep collagen grafts performed similarly to AVF.
Area of Science:
- Vascular Surgery
- Nephrology
- Biomaterials
Background:
- Vascular access is crucial for hemodialysis.
- Autogenous arteriovenous fistulas (AVF) and interposition grafts are common methods.
- Comparing their long-term outcomes is essential for patient care.
Purpose of the Study:
- To compare the efficacy of autogenous arteriovenous fistulas (AVF) versus interposition graft fistulas for hemodialysis access.
- To evaluate patency rates and identify factors influencing them.
Main Methods:
- Retrospective clinical study.
- Life table analysis used to calculate primary and secondary patency rates.
- Log rank test applied to compare patency factors.
Main Results:
- Over 12 years, 720 fistulas were created (429 AVF, 291 grafts).
- Secondary patency at 1/3 years: AVF 74/64%, bovine xenografts 56/24%, PTFE grafts 58/40%, sheep collagen grafts 71/45%.
- Sheep collagen grafts showed similar patency to AVF; women had significantly lower patency rates.
Conclusions:
- Autogenous arteriovenous fistulas (AVF) and interposition grafts offer comparable long-term patency for hemodialysis.
- Sheep collagen grafts present a viable alternative to AVF.
- Gender is a significant factor affecting fistula patency.