Es. Schuman et al., REINFORCED VERSUS NONREINFORCED POLYTETRAFLUOROETHYLENE GRAFTS FOR HEMODIALYSIS ACCESS, The American journal of surgery, 173(5), 1997, pp. 407-410
BACKGROUND: Two major types of polytetrafluoroethylene (PTFE) graft ma
terial have been available for the past 20 years, Previous studies hav
e suggested that nonreinforced PTFE performs better as a hemodialysis
conduit than reinforced PTFE. We have had experience with both materia
ls for the past 20 years. METHODS: This is an outcome study that is ba
sed on concurrent and retrospective data. Patients were accrued into t
he study from 1987 to 1995. There were 632 grafts that were entered on
to a data base and analyzed by a biostatistician. RESULTS: Nonreinforc
ed PTFE performed better than reinforced PTFE in every category and su
bgroup, Both mean duration and life-table analysis of the primary pate
ncy were statistically significant (P < 0.05), The secondary patencies
were similar, with 80% of the nonreinforced and 77% of the reinforced
functioning at 1 year, The median duration for secondary patency of a
ll grafts was 1,554 days, Diabetic patients comprised 50% of the patie
nt population, CONCLUSION: Nonreinforced PTFE performs better than rei
nforced PTFE as a hemodialysis conduit. Until a multicentered prospect
ive randomized study can be achieved, a preponderance of data suggests
that nonreinforced PTFE should be the material of choice for hemodial
ysis access. (C) 1997 by Excerpta Medica, Inc.