Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지
DOI QR코드

DOI QR Code

Surgical Outcomes of Forearm Loop Arteriovenous Fistula Formation Using Tapered versus Non-Tapered Polytetrafluoroethylene Grafts

  • Han, Sun (Department of Thoracic and Cardiovascular Surgery, Dankook University College of Medicine) ;
  • Seo, Pil Won (Department of Thoracic and Cardiovascular Surgery, Dankook University College of Medicine) ;
  • Ryu, Jae-Wook (Department of Thoracic and Cardiovascular Surgery, Dankook University College of Medicine)
  • Received : 2016.09.06
  • Accepted : 2016.11.14
  • Published : 2017.02.05
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Tapered grafts, which have a smaller diameter on the arterial side, have been increasingly used for arteriovenous fistula (AVF) formation. We compared the outcomes of 4-6-mm tapered and 6-mm straight forearm loop arteriovenous grafts. Methods: A total of 103 patients receiving forearm loop arteriovenous grafts between March 2005 and March 2015 were retrospectively analyzed and separated into 2 groups (group A, 4- to 6-mm tapered grafts, n=78; group B, 6-mm straight grafts, n=25). In each group, complications and patency rates after surgery were assessed. Results: Clinical characteristics and laboratory results, except for cerebrovascular disease history (group A, 7.7%; group B, 28.0%; p=0.014), were similar between the groups. No significant differences were found for individual complications. Kaplan-Meier survival analysis revealed no significant differences in 1-year, 3-year, and 5-year patency rates between groups (61.8%, 44.9%, and 38.5% vs. 62.7%, 41.1%, and 35.3%, respectively). Conclusion: We found no significant differences in complication and patency rates between the tapered and straight graft groups. If there are no differences in complication and patency between the two graft types, tapered grafts may be a valuable option for AVF formation in light of their other advantages.

Keywords

References

  1. ESRD Registry Committee, Korean Society of Nephrology. Current renal replacement therapy in Korea [Internet]. Seoul: Korean Society of Nephrology; 2015 [cited 2016 May 1]. Available form: http://www.ksn.or.kr/journal/2015/index.html.
  2. Kim DS, Kim SW, Kim JC, Cho JH, Kong JH, Park CR. Clinical analysis of hemodialysis vascular access: comparision of autogenous arterioveonus fistula & arteriovenous prosthetic graft. Korean J Thorac Cardiovasc Surg 2011;44: 5-31.
  3. Papaioannou TG, Stefanadis C. Vascular wall shear stress: basic principles and methods. Hellenic J Cardiol 2005; 6:9-15.
  4. Van Tricht I, de Wachter D, Tordoir J, Verdonck P. Hemodynamics in a compliant hydraulic in vitro model of straight versus tapered PTFE arteriovenous graft. J Surg Res 2004;116:297-304. https://doi.org/10.1016/S0022-4804(03)00303-2
  5. Dammers R, Planken RN, Pouls KP, et al. Evaluation of 4-mm to 7-mm versus 6-mm prosthetic brachial-antecubital forearm loop access for hemodialysis: results of a randomized multicenter clinical trial. J Vasc Surg 2003; 37:143-8. https://doi.org/10.1067/mva.2002.25
  6. Suding PN, Wilson SE. Strategies for management of ischemic steal syndrome. Semin Vasc Surg 2007;20:184-8. https://doi.org/10.1053/j.semvascsurg.2007.07.009
  7. Park J, Jun H, Chung M, et al. Changes of cardiac function by the arteriovenous fistula in end stage renal failure patients. J Korean Vasc Surg Soc 1998;14:309-15.
  8. Vascular Access 2006 Work Group. Clinical practice guidelines for vascular access. Am J Kidney Dis 2006;48 Suppl 1:S176-247. https://doi.org/10.1053/j.ajkd.2006.04.029
  9. Polo JR, Ligero JM, Diaz-Cartelle J, Garcia-Pajares R, Cervera T, Reparaz L. Randomized comparison of 6-mm straight grafts versus 6- to 8-mm tapered grafts for brachial-axillary dialysis access. J Vasc Surg 2004;40:319-24. https://doi.org/10.1016/j.jvs.2004.05.005