Effectiveness of polytetrafluoroethylene graft for hemodialysis access and treatment of graft occlusion / 中国医学科学院学报

ABSTRACT

<p><b>OBJECTIVE</b>To assess the patency and complications of the polytetrafluoroethylene (PTFE) graft for hemodialysis access and to summarize the experiences in the treatment of graft occlusions.</p><p><b>METHODS</b>The clinical data of 30 patients who underwent forearm PTFE graft for hemodialysis access from March 2003 to December 2008 in our hospital were retrospectively analyzed.</p><p><b>RESULTS</b>Patients were followed up for (28.7+/-17.6) months (range 8-78 months).The peri-operative mortality was zero. Primary patency rate was 70.0% at Year 1 and 56.7% at Year 2. Accumulative secondary patency rate was 90.0% and 80.0%, respectively at Year 1 and Year 2. Postoperative complications included graft thrombosis (n=13, 43.3%), venous anastomosis stenosis (n=1, 3.3%), graft infection (n=2, 6.7%), and edema of the forearm (n=10, 33.3%). Totally 24 graft revisions were performed, including thrombectomy (12 times), thrombectomy and venous anastomosis plasty with artificial patch (4 times), arterial and venous anastomosis plasty with patch (2 times), venous anastomosis angioplasty with a balloon (2 times), new graft hemodialysis access construction in the contralateral arm (1 case), and graft removal (3 cases).</p><p><b>CONCLUSIONS</b>PTFE graft is an important backup hemodialysis access in uremic patients. Proper revision according to different cause of graft occlusions can prolong the service time of the graft.</p>