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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.
Objectives:
To compare the outcome of autogenous arteriovenous fistulas (AVF) with interposition graft fistulas for hemodialysis access.
Design:
Retrospective clinical study.
Setting:
Department of Surgery, Zurich University Hospital.
Methods:
Primary and secondary patency rates were calculated by life tables. Factors potentially affecting patency were studied by comparison of life tables using the log rank test.
Main Results:
From 1980 to 1992, 414 patients were operated on for long-term vascular access. 720 fistulas were created including 429 AVF and 291 interposition grafts (150 bovine xenografts, 69 PTFE grafts, 59 sheep collagen grafts, 10 autologous and 1 homologous vein grafts). Secondary patency rates after 1 and 3 yr were 74/64% in AVF, 56/24% in bovine xenografts, 58/40% in PTFE grafts and 71/45% in sheep collagen grafts. The latter performed not significantly worse than AVF. Primary and secondary patency rates were significantly lower in women.