The Patency Rate and Complications of Polytetrafluoroethylene Vascular Access Grafts in Hemodialysis Patients: A Prospective Study from Iran

The objective of this study was to evaluate the patency rate as well as complications of polytetrafluoroethylene vascular grafts (ePTFE) in patients on hemodialysis (HD). In a prospective study, 84 patients who underwent implantation of vascular grafts for HD at the Sina Hospital, Tehran, Iran, between April 2001 and April 2004, were evaluated. The mean age of the patients was 55 + 12 years; and 42 patients were male. Upper and lower limb vascular access grafts were implanted in 42 patients each. The patients were followed-up for a mean of 24 months. During this period, 30 patients (35.7%) developed thrombosis and two (2.4%) had bleeding. Graft infection and pseudo-aneurysm were observed in five (6%) and two (2.4%) patients, respectively. The primary 24-month patency rate was 43%. The patency rates in patients with and without hypertension were 29.7% and 62.2%, respectively (P 0.03). Upper extremity grafts had 60% patency rate while lower extremity grafts had a patency rate of 26% (P 0.05). Our study indicates that ePTFE vascular graft seems to be an appropriate vascular access when arteriovenous fistulas cannot be constructed . Educating patients and maintaining proper care of the grafts will help in reducing prevalence of infection, thrombosis and other complications, can increase the patency rate of the grafts and consequently, decrease the morbidity rate in HD patients.