Survival of prosthetic crafts of different materials after impairment of anative arteriovenous fistula in hemodialysis patients

In our department, hemodialysis vascular accesses with graft, are used in p atients with impairment of native distal and proximal arteriovenous fistula s (AVF-E). The aim of this study was to compare the survival of grafts of d ifferent materials (PTFE vs. bovine vein) in these patients. From 1991 to 1 999, we prospectively evaluated 53 patients (35 women, 18 men, age 68 +/- 1 1 years, on dialysis for 70 +/- 65 months). Fifty-three PTFE, 10 reinforced PTFE, and 22 bovine vein grafts were placed. We evaluated the primary pate ncy (PP) (days between fistula placement and the last dialysis before throm bosis occurred) and the secondary patency (SP) (days between fistula placem ent and the last dialysis treatment before it was considered lost) by separ ating PTFE survival from that of bovine veins. In the same patients, we als o evaluated the survival of the native arteriovenous fistulas (AVF-E) durin g the pregraft period. Furthermore, we evaluated 404 patients (172 women, 2 32 men, age 65 +/- 14 years, on dialysis for 50 +/- 53 months) in whom only AVF-E were placed during the same follow-up period. Craft and AVF-E surviv al were calculated according to the Kaplan-Meier method. In patients with g rafts, the PP at 1 year was 17.4% for PTFE and 23.9% for bovine veins. At 1 2 months, the SP of bovine veins was significantly higher than that of PTFE (81,9% vs. 50%, p < 0.04). In the patients who only had AVF-E, the PP and SP was, respectively, 43% at 12 months and 52.4% at 50 months. A preliminar y experience in 22 patients with a 20 month follow-up confirms better survi val of bovine veins than PTFE (p < 0.04).