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KMID : 0391119960050010051
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Ulsan University Medical Journal
1996 Volume.5 No. 1 p.51 ~ p.58
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Comparison of patency between native vein & polyterafluoroethylene for internal arteriovenous fistula
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Abstract
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The internal arteriovenous fistula is essential treatment modality of end stage renal disease. The majority of the end stage renal disease petients depend on hemodialysis, including those waiting for kidney transplantation or those suffering from
rejection after kidney transplantation to sustain their lives. The long term patency and low complication rate of internal arteriovenous fistula are important for the quality of patient's life. The aim of this study is to compare primary and
secondary
patency between native vein & polytetrafluoroethylene(PTFE) for internal arteriovenous fistula(AVF) for long-term hemodialysis. The influence of diabetes on the primary and secondary patency of internal arteriovenous fistula is also studied.
All native vein & PTFE AVF constructed between June 1989 & December 1994 at Asan Medical Center were retrospectively reviewed. Wilcoxon test was used to compare the primary and secondary patency rates of native vein AVF(n:299) with PTFE
AVF(n:154)
The ratio of male to female was 318:210(1.5:1). The diabetes patient was 184cases(34.8%). The primary patency rate of native vien showed no significant difference to that of PTFE AVF(p=0.0539). The secondary patency rate of native vein is
superior
to
that of PTFE AVF(p=0.0428). Both of primary and secondary patency rate in internal arteriovenous fistula for non-DM patients were superior to DM patients(p=0.0008, p=0.0105).
In conclusion, we can use the PTFE as an alternative choice of material for internal arteriovenous fistula if there is no suitable native veins. We could expect good patency rate under the appropriate indications. We must try salvage procedure
first on
the failing graft before making another internal arteriovenous fistula on the any other site, especially on the native vein cases. Diabetes is a negative factor on the primary and secondary patency of internal arteriovenous fistula.
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