Reinforced versus nonreinforced polytetrafluoroethylene grafts for hemodialysis access

American Journal of Surgery
E S SchumanG F Gross

Abstract

Two major types of polytetrafluoroethylene (PTFE) graft material have been available for the past 20 years. Previous studies have suggested that nonreinforced PTFE performs better as a hemodialysis conduit than reinforced PTFE. We have had experience with both materials for the past 20 years. This is an outcome study that is based on concurrent and retrospective data. Patients were accrued into the study from 1987 to 1995. There were 632 grafts that were entered onto a data base and analyzed by a biostatistician. Nonreinforced PTFE performed better than reinforced PTFE in every category and subgroup. Both mean duration and life-table analysis of the primary patency were statistically significant (P < 0.05). The secondary patencies were similar, with 80% of the nonreinforced and 77% of the reinforced functioning at 1 year. The median duration for secondary patency of all grafts was 1,554 days. Diabetic patients comprised 50% of the patient population. Nonreinforced PTFE performs better than reinforced PTFE as a hemodialysis conduit. Until a multicentered prospective randomized study can be achieved, a preponderance of data suggests that nonreinforced PTFE should be the material of choice for hemodialysis access.

References

May 1, 1988·American Journal of Surgery·E S SchumanB A Standage
May 1, 1985·Southern Medical Journal·O E Winsett, F J Wolma

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Citations

Jul 8, 1999·Cardiovascular Surgery : Official Journal of the International Society for Cardiovascular Surgery·S N HurlbertD S Summer
Mar 11, 2004·Seminars in Vascular Surgery·Larry A Scher, Howard E Katzman
Mar 15, 2001·American Journal of Surgery·J W CookP Heinl
Jun 24, 2003·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·U Sulkowski, H Schulte

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