Retrospective analysis of 50 cases polytetrafluorothylene grafts

Purpose: To evaluate the patency, complications and other corresponding factors related with polytetrafluorothylene (PTFE) grafts as a secondary hemodialysis vascular access. Methods: A retrospective analysis was conducted on 50 cases PTFE grafts in 41 patients placed by one experienced vascular surgeon in one hospital during the period from Oct 1997 to Oct 2000. Results: There were 25 female and 16 male patients with a median age (63 ± 10) years (range 28-81 years). Eighteen patients were diabetes while 23 were non-diabetes. All patients had previous creations of native A-V fistulas (AVF) before the placement of PTFE grafts. Thirty-six cases were over upper forearms, 13 cases were over lower extremities and 1 case over subclavic. The 0.5, 1,2 years cumulative patency rates of the 50 PTFE grafts was 65.66%, 61.21% and 43.72% respectively. There was no significant difference of the patency rates between the diabetic and non-diabetic patients (P > 0.05) and between the upper forearm and lower extremities grafts (P > 0.05). Complications include graft thrombosis (31 cases), pseudoanurism (7 cases), infection (5 cases), graft exposure (3 cases), seroma (2 cases), bleeding (1 case) and venous congestion (1 case). Conclusions: PTFE grafts offer an alternative vascular access for chronic hemodialysis patients, but considering their patency rates and complication profile, the native arteriovenous fistula should continue to be the first choice procedure.