Comparison of autogenous basilic vein, polytetrafluoroethylene and polycarbonate grafts for haemodialysis access

Abstract Objectives: This study aims to present data obtained by comparing the results of three different kinds of arterio-venous fistula (AVF) in haemodialysis patients. Patients and methods: One hundred twenty (120) patients were operated with autogenous brachiobasilic (BBF) AVF, upper arm polytetrafluoroethylene (PTFE) or polycarbonate-urethane (PCU) graft AVF in our centre between January 2015 and January 2018. They were enrolled for a retrospective study into three groups; BBF Group (n=54), PTFE Graft Group (n=36), PCU Graft Group (n=30). Their data was analysed, primary and secondary patency rates, complications and cannulation time were calculated. Results: Primary patency rates of the 1st, 2nd and 3rd years were recorded to be respectively 81.4%, 72.2% and 59.2% in the Autogenous Arteriovenous Fistula (BBF) Group; 61.1%, 55.5% and 44.4% in the PTFE Group and 63.3%, 60% and 46.6% in the PCU Group. Infections occurred in 3.7% of BBF patients, in 8.3% of PTFE patients and 10% of PCU patients. First cannulation times were: 69± 17 (day) in BBF Group, 20 ± 5 (day) in PTFE Group and 10± 3(day) in PCU Group. Conclusion: BBF was observed to perform better than AVG in terms of primary and secondary patency and to result in low infection rates. On the other hand, first cannulation was performed earlier in both graft AVFs. There was no significant difference between PTFE and PCU in terms of our outcomes.

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  • References1 Ethier J, Mendelssohn DC, Elder SJ, et al. Vascular access use and outcomes: an international perspective from the Dialysis Outcomes and Practice Patterns Study. Nephrol Dial Transplant 2008;23:3219-26.
  • References2 Allon M. Current management of vascular access. Clin J Am Soc Nephrol 2007;2:786-800.
  • References3 Vascular Access 2006 work Group. Clinical practice guidelines for vascular access. Am J Kidney Dis 2006;48:S176-S247.
  • References4 Oliver MJ, McCann RL, Indridason OS, et al. Comparison of Transposed Brachiobasilic Fistulas to Upper Arm Grafts and Brachiosephalic Fistulas. Kidney International 2001;60:1532-1539.
  • References5 Allon M, Lok CE. Dialysis Fistula or Graft: The Role for Randomized Clinical Trials. Clin J Am Nephrol 2010;5:2348-2354.
  • References6 Duk-Sil K, Sung-Wan K, Jun-Chul K, et al. Clinical Analysis of Hemodialysis Vascular Access: Comparision of Autogenous Arteriovenous Fistula & Arteriovenous Prosthetic Graft. Korean Thorac Cardiovasc Surg 2011;44:25-31.
  • References7 Chieh-Hung L, Po-Jen K, Yun-Hen L, et al. Brachiobasilic Fistula as a Secondary Access Procedure: An Alternative to a Dialysis Prosthetic Graft. Chang Gung Med J 2004;27:816-23.
  • References8 Dagher F, Gelber R, Ramos E, et al. The use of basilic vein and brachial artery as an A-V fistula for long term hemodialysis. J Surg Res 1976;20:373-6.
  • References9 Dahduli SA, Qattan NM, Al-Kuhaymi RA, Al-Jabreen MA, Al-Khadeer AA. Mobilization and superficialization of basilic vein for brachio basilic fistula. Saudi Med J 2002;23:1203-5.
  • References10 Taghizadeh A, Dasgupta P, Khan MS, Taylor J, Koffman G. Long-term outcomes of brachiobasilic transposition fistula for hemodialysis. Eur J Vasc Endovasc Surg 2003;26:670-2.
  • References11 Burkhart HM, Cikrit DF. Arteriovenous fistulae for hemodialysis. Semin Vasc Surg 1997;10:162-5.
  • References12 Tordoir JHM, Bode AS, Peppelenbosch N, et al. Surgical or endovascular repair of thrombosed dialys vasculer access: is there any evidence? J Vasc Surg 2009;50:953-6.
  • References13 Li PK, Chow KM. Infectious complications in dialysis epidemiogy and outcomes. Nat Rev Nephrol 2011;8:77-88.
  • References14 Malik J, Tuka V, Kasalova Z, Chytilova E, Slavikova M, Clagett P, Davidson I, Dolmatch B, Nichols D, Gallieni M. Understanding the dialysis access steal syndrome. A review of the etiologies, diagnosis, prevention and treatment strategies. J Vasc Access. 2008 Jul-Sep;9(3):155-66.
  • References15 Ryan SV, Calligaro KD, Dougherty MJ. Management of hemodialysis access infections. Semin Vasc Surg. 2004 Mar;17(1):40-4. doi: 10.1053/j.semvascsurg.2003.11.004.