Comparison of upper forearm polytetrafluoroethylene grafts in hemodialysis patients: Curved or loop?

Patients and methods: A total of 64 patients (31 males, 33 females; mean age 53.4±18.0 years; range, 15 to 82 years) who underwent operation between May 2009 and May 2017 were retrospectively evaluated. The patients were divided into two groups: Group 1 (n=32) included forearm brachial artery ante-cubital basilic vein loop with a PTFE AV graft and Group 2 (n=32) included upper arm brachial artery axillary vein curved with a PTFE AV graft. The patency and complication rates were compared between the groups.

Results: In Group 1, the primary patency rates at three, six, 12, 18, and 24 months were 78%, 68%, 25%, 9%, and 3%, respectively. In Group 2, the primary patency rates at three, six, 12, 18, and 24 months were 87%, 84%, 65%, 43%, and 31%, respectively. The patency rate was statistically significantly higher in the curved group (log rank: p=0.001). The rate of thrombosis in the postoperative period was 75% (n=24) and 40% (n=13) in Group 1 and Group 2, respectively, indicating a statistically significantly higher rate in Group 1 (p=0.011).

Conclusion: The results of our study suggest that curved AV grafts are superior than loop AV grafts regarding the primary patency rates and postoperative thrombosis.