Comparison of outcomes of arteriovenous grafts and fistulas at a single Veterans' Affairs medical center

Am J Surg. 2008 Nov;196(5):641-6. doi: 10.1016/j.amjsurg.2008.07.013. Epub 2008 Sep 27.


Background: Before 2003, almost all dialysis access procedures performed at the G.V. Montgomery Veterans' Affairs Medical Center were arteriovenous grafts. In mid-2003, it was decided to place fistulas in most patients. This study compared the patency rates and frequency of interventions to maintain function between the 2 procedures.

Methods: Patency rates for 64 grafts and 50 fistulas were computed using Kaplan-Meier life-tables and compared using the Cox-Mantel log- rank test. The frequency of interventions to maintain function was compared using a Poisson model.

Results: Primary patency of grafts at 1 and 2 years was 39% and 26%, and that of fistulas was 44% and 37%. Secondary patency of grafts at 1 and 2 years was 71% and 63%, and that of fistulas was 75% and 72%. Neither difference reached significance. The difference in interventions also was insignificant.

Conclusions: Switching from grafts to fistulas did not significantly improve the patency and frequency of interventions.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arteriovenous Shunt, Surgical*
  • Blood Vessel Prosthesis Implantation*
  • Female
  • Hospitals, Veterans
  • Humans
  • Male
  • Middle Aged
  • Poisson Distribution
  • Proportional Hazards Models
  • Renal Dialysis*
  • Vascular Patency*