Long‐term function of vascular access for hemodialysis

OBJECTIVES: To compare the outcome of autogenous arteriovenous fistulas (AVF) with interposition graft fistulas for hemodialysis access. DESIGN: Retrospective clinical study. SETTING: Department of Surgery, Zurich University Hospital. METHODS: Primary and secondary patency rates were calculated by life tables. Factors potentially affecting patency were studied by comparison of life tables using the log rank test. MAIN RESULTS: From 1980 to 1992, 414 patients were operated on for long-term vascular access. 720 fistulas were created including 429 AVF and 291 interposition grafts (150 bovine xenografts, 69 PTFE grafts, 59 sheep collagen grafts, 10 autologous and 1 homologous vein grafts). Secondary patency rates after 1 and 3 yr were 74/64% in AVF, 56/24% in bovine xenografts, 58/40% in PTFE grafts and 71/45% in sheep collagen grafts. The latter performed not significantly worse than AVF. Primary and secondary patency rates were significantly lower in women.