Expanded polytetrafluoroethylene graft fistula for chronic hemodialysis

In a retrospective study of 66 polytetrafluoroethylene arteriovenous fistulae (PTFE) and 71 bovine carotid heterograft arteriovenous fistulae (BCH) for dialysis access, PTFE had a higher patency rate than BCH at 12 months (62.4 versus 32.5%). PTFE was easier to work with and easier to handle in the face of infection. The lateral upper arm approach to placement of the PTFE graft is desirable in patients who have had multiple previous access procedures because this area is usually free from scarring, is distant from neurovascular structures, and provides a greater length of graft for needle punctures.