Comparative Study between Loop Saphenous Vein and Prosthetic Thigh Vascular Access Graft for Haemodialysis

Abstract

Background: renal disease is an international problem with a high mortality and morbidity especially in the lowincome countries. Haemodialysis can help patients, but with multiple complications and challenges associated with the procedure. One of these challenges is exhausted veins in the upper limb. Aim of the work: this study aimed to compare using of great saphenous vein bridge fistula versus prosthetic vascular graft, for creating bridge between superficial femoral artery and vein, for the purpose of regular haemodialysis. Patients and Methods: 40 chronic renal failure patients were included. Patients were subjected to full history, clinical examination, investigations and Doppler/duplex scanning for both arterial and venous systems. Follow up was done immediately at the first postoperative day then at one week, 3 weeks, 3 months, 6 months, 9 months and after one year as regards patency, functioning of the graft as well as complications. Results: early death within 30 days of surgery did not occur. Thrombosis was more frequent in PTFE AV graft loop group while all insufficient graft flow (< 200 mL/minute) cases were in SVI group. The numbers of puncture site complications were similar; however, bleeding was more frequent in PTFE group (p = 0.011). None of the patients showed clinical signs or symptoms of graft infection Conclusions: autogenous arteriovenous fistula reveals better primary patency rate than that of prosthetic arteriovenous graft with statistically significant results (p = 0.04). Autogenous arteriovenous fistula showed statistically better secondary patency rate (p = 0.001).