Long-term patency of polytetrafluoroethylene graft fistulas.

Polytetrafluoroethylene grafts have been the mainstay for hemoaccess at our dialysis unit since 1976. Of 528 grafts placed in the forearm, 81 were evaluated for long-term patency and complication rates. When appropriate diagnostic studies and clinical signs delineate the cause of graft problems, a variety of surgical techniques can be used to maintain graft patency. The overall patency rate was 81 percent at 4.47 years. There were 3.5 complications per graft and 1 procedure per 1.25 years of follow-up. Over two thirds of the grafts had minimal complications and showed a 95 percent patency rate at 4.76 years. Impra grafts seemed to fare better than Gore-tex grafts, but their patency and duration were similar. Polytetrafluoroethylene grafts are easy to use, easy to revise and repair, have a long shelf life, and can withstand repeated dialysis access for many years.