내동정맥루수술에 있어서 자가정맥과 인조혈관(PTFE)의 개존율 비교

Abstract

The internal arteriovenous fistula is essential treatment modality of end stage renal disease. The majority of the end stage renal disease patients depend on hemodialysis, including those waiting for kidney transplantation or those suffering from rejection after kidney transplantation to sustain their lives. The long team patency and low complication rate of internal arteriovenous fistula are important for the quality of patient's life. The aim of this study is to compare primary and secondary patency between native vein & polytetrafluoroethylene (PTFE) for internal arteriovenous fistula(AVF) for long - term hemodialysis. The influence of diabetes on the primary and secondary patency of internal arteriovenous fistula is also studied.

All native vein & PTFE AVF constructed between June 1989 & December 1994 at Asan Medical Center were retrospectively reviewed. Wilcoxon test was used to compare the primary and secondary patency rates of native vein AVF(n:299) with PTFE AVF(n:154).

The ratio of male to female was 318: 210(1.5:1). The diabetes patient was 184cases(34.8%). The primary patency rate of native vien showed no significant difference to that of PTFE AVF(p=0.0539). The secondary patency rate of native vein is superior to that of PTFE AVF(p=0.0428). Both of primary and secondary patency rate in internal arteriovenous fistula for non-DM patients were superior to DM patients(p=0.0008, p=0.0105).

In conclusion, we can use the PTFE as an alternative choice of material for internal arteriovenous fistula if there is no suitable native veins. We could expect good patency rate under the appropriate indications. We must try salvage procedure first on the failing graft before making another internal arteriovenous fistula on the any other site, especially on the native vein cases. Diabetes is a negative factor on the primary and secondary patency of internal arteriovenous fistula.

The internal arteriovenous fistula is essential treatment modality of end stage renal disease. The majority of the end stage renal disease patients depend on hemodialysis, including those waiting for kidney transplantation or those suffering from rejection after kidney transplantation to sustain their lives. The long team patency and low complication rate of internal arteriovenous fistula are important for the quality of patient's life. The aim of this study is to compare primary and secondary patency between native vein & polytetrafluoroethylene (PTFE) for internal arteriovenous fistula(AVF) for long - term hemodialysis. The influence of diabetes on the primary and secondary patency of internal arteriovenous fistula is also studied.

All native vein & PTFE AVF constructed between June 1989 & December 1994 at Asan Medical Center were retrospectively reviewed. Wilcoxon test was used to compare the primary and secondary patency rates of native vein AVF(n:299) with PTFE AVF(n:154).

The ratio of male to female was 318: 210(1.5:1). The diabetes patient was 184cases(34.8%). The primary patency rate of native vien showed no significant difference to that of PTFE AVF(p=0.0539). The secondary patency rate of native vein is superior to that of PTFE AVF(p=0.0428). Both of primary and secondary patency rate in internal arteriovenous fistula for non-DM patients were superior to DM patients(p=0.0008, p=0.0105).

In conclusion, we can use the PTFE as an alternative choice of material for internal arteriovenous fistula if there is no suitable native veins. We could expect good patency rate under the appropriate indications. We must try salvage procedure first on the failing graft before making another internal arteriovenous fistula on the any other site, especially on the native vein cases. Diabetes is a negative factor on the primary and secondary patency of internal arteriovenous fistula.