Arteriovenous grafts have higher secondary patency in the short term compared with autologous fistulae

作者：Allemang Matthew T; Schmotzer Brian; Wong Virginia L; Lakin Ryan O; Woodside Kenneth J; Schulak James A; Wang John; Kashyap Vikram S^*

来源：American Journal of Surgery, 2014, 208(5): 800-805.

DOI：10.1016/j.amjsurg.2014.01.010

• Dialysis access
• Prosthetic graft
• PTFE
• Patency

BACKGROUND: To estimate patency of arteriovenous fistulas (AVFs) and grafts (AVGs) for dialysis access. %26lt;br%26gt;METHODS: Records of all adult patients who had a dialysis access placed from January 2008 to June 2011 were retrospectively reviewed. %26lt;br%26gt;RESULTS: A total of 494 patients with 655 accesses (390 AVFs, 265 AVGs) were examined. We found that AVG fared worse in assisted primary patency. But AVG had superior secondary patency up to 1.2 years (hazard ratio [HR] .6, confidence interval [CI]: [.4 to .8]) and was no different than AVF after 1.2 years. (HR 1.6, CI: [.9 to 3.1]). On univariate analysis, dialysis catheters negatively impacted assisted primary patency (HR 1.4, CI: [1.09 to 1.77]). %26lt;br%26gt;CONCLUSIONS: AVG can be maintained with higher rates of secondary patency in the short term and are no different in the long term. This result suggests that in patients with limited life expectancy an AVG may be an effective alternative to an AVF to reduce both catheter time and associated complications.

• 出版日期2014-11