Comparing the saphenous vein with the Gore-tex bridge fistula in thigh for chronic hemodialysis

Background: Performing chronic hemodialysis in patients suffering from end stage renal disease needs a suitable vascular access like A-V fistula in upper limbs, bridge fistula in upper or lower limbs, and use of permanent and temporary catheters. The purpose of this study is to compare the saphenous vein loop fistula as a venous autograft versus using the synthetic Gore-tex vascular graft for creating loop A-V fistula in thigh for hemodialysis. Methods: In the context of a prospective randomized study, seventy patients needing bridge fistula for dialysis access were randomly divided into two groups. We performed the loop saphenous A-V fistula in the test group and the Gore-tex loop bridge fistula in the control group. An assessment was made of the function criteria (fistula thrill and murmur) and complications ( infection and thrombosis) in planned intervals. At the end of a year of follow-up the flow rate of all fistulas were assessed by means of Doppler sonography. These data were compared with each other. Results: Comparing the function criteria (fistula murmur and thrill) of the loop saphenous A-V fistula and the Goretex method showed no significant differences ( p< 0.8). There was no significant difference between the two groups in thrombosis ( p< 0.8). The infection rate of the Gore-tex method was significantly high ( p< 0.05). However, the flow rates showed no significant differences ( p< 0.8). Conclusions: Essentially we showed that arteriovenous fistula was an acceptable alternative for arteriovenous graft in the thigh for performing chronic hemodialysis and that saphenous vein loop arteriovenous fistula was superior to Gore-tex loop arteriovenous graft from some aspects.