Graft materials as vascular substitutes for hemodialysis access construction

Abstract

Objectives The purpose of this study was to compare the patency rate and associated complications using different types of synthetic grafts used in hemodialysis access. Background Polytetrafluoroethylene (PTFE) recently gained popularity as a graft material for hemodialysis access. PTFE has been modified by many ways such as adding rings [ringed polytetrafluoroethylene (rPTFE)] or adding an outer layer of polyethylene terephthalate [hybrid polytetrafluoroethylene (hPTFE)]. Modifications in PTFE have been developed to improve the outcome; however, to date no PTFE graft has demonstrated clear superiority over competitive products. Patients and methods The study was performed as a prospective observational cohort study between January 2019 and January 2022 at Menoufia University Hospitals. In all, 50 patients underwent brachio-axillary straight graft using different graft type's rPTFE, standard polytetrafluoroethylene (sPTFE), and hPTFE (fusion graft). Patency and complications rates were compared between the three groups. Results We found that rPTFE grafts have lower thrombosis and infection rates than hPTFE and sPTFE grafts. Also, there was no pseudoaneurysm or postdialysis subcutaneous hematoma formation in the rPTFE group during the follow-up period. Also, the 1-year primary patency rates were 73.3, 73.7, and 81.3% in the hPTFE, sPTFE, and rPTFE groups, respectively. Conclusion The feasibility and superiority of externally supported arteriovenous graft in comparison to nonsupported arteriovenous graft for primary patency in dialysis access has been shown by this study.