Evaluation of Gore-Tex graft patency in hemodialysis access

The purpose of this retrospective study was to analyze the patency and complications of Gore-Tex grafts used in hemodialysis (HD) access. In the last 16 years, 1649 surgical procedures were performed on 655 patients to ensure and maintain permanent HD access. The study group consisted of 64 HD patients on whom 81 vascular synthetic PTFE Gore-tex grafts were performed. There were 28 males and 36 females, 3 of them were children (4.7%). Mean age was 54.2 years (range 15-77). Two types of Gore-Tex prosthesis were used: Diastat and Stretch. All grafts were implanted in the upper extremities. Kaplan-Meier survival curves were calculated to determine primary and secondary patency. Log-rank analysis was used to determine differences between curves. Primary and secondary patency at 12 months was 52.5% and 67.5%, and at 18 months respectively 41.5% and 58.2%. The Diastat graft had a lower primary and secondary patency compared with the Stretch graft (respectively p = 0.02 and p = 0.008). Factors such as gender, coexisting diabetes and hypertension did not determine graft patency. Thrombosis was one of the most frequent complications. The remaining complications included stenosis, pseudoaneurysms, infection, steal syndrome and seroma. On the basis of our experience Stretch grafts appear a better option for creating vascular access for HD than Diastat grafts.