The Redo-Surgery of Expanded Polytetrafluoroethylene (PTFE) Arteriovenous Fistulas for Hemodialysis

Abstract

The Brescia-Cimino fistula, 1 which is considered the best modality of vascu lar access for chronic hemodialysis available up to now, is not always feasible unfortunately principally for anatomical reasons. A second-choice technique must therefore be selected in 3% to 25%.2,3,4 We have applied the E-PTFE pro stheses (expanded polytetrafluoroethylene) which were recommended at an early stage for chronic vascular accesss 5,6 after saphenous loops and bovine grafts have tended to provide disappointing results after initial enthusiasm.7,8,9,10 How ever, this specially prepared teflon prosthesis which has simple technical proc essing and into which with limitations a needle can be introduced at an early point in time is also an operation-specific problem which will be discussed in the present paper.