Hemodiyaliz Gerektiren Kronik Böbrek Yetmezlikli Hastalarda Arteriovenöz Fistül Oluşturmak İçin E-Politetrafloretilen Greft Kullandığımız Hastalardaki Klinik Deneyimlerimiz

Background: A arteriovenous fistula performing with e-PTFE (expanded polytetrafluoroethylene) vascular graft allows vascular access for hemodialysis where a primary fistula is not possible . We aimed to evaluate our clinical experience related to this prosthetic graft. Material and Methods: We performed arteriovenous fistula using e (expanded)-PTFE graft in the 35 patients with end-stage renal failure requiring hemodialysis between September 2003 and November 2007. The mean age of patients were 55.09±12.2 (range,23 to 74). There were 16 women and 19 men. Beforehand in all patients were performed direct arteriovenous fistula in the upper extremity and these arteriovenous fistulas wasn"t functional. All patients were performed doppler ultrasound examination of the upper and lower extremity arteries and veins. The patients were used e-PTFE (Gore Intering vascular graft) graft 7 mm in diameter tapered to 4mm at the arterial site. Results: Between brachial artery and axillary vein in 24 patients (68.6%), between radial artery and antecubital vein in 6 patients (17.1%), between femoral artery and femoral vein in 5 patients (14.3%) were performed arteriovenous fistula. In all patients primary patency rate were 81.9%, 66.6%,and 26.6% at 6, 12, and 24 months. Secondary patency rates at 6, 12, and 24 months were 78.2%, 33.3%, and 17.6%. There were no perioperative morbidity and mortality. Mean followup was 27.22±12.04 months (range, 2 to 48 months). Conclusion: e-PTFE grafts provide satisfactory patency rate. Preoperative doppler ultrasonography and venography examination are important for showing of probable graft configurations. Thrombosis is the most complication.