ABSTRACT
Patients with chronic renal failure need to have arteriovenous (AV) fistulas or grafts patent and with adequate flow to undergo effective dialysis. Long-term patency of AV fistulas has limitations and more than 85% of AV fistulas thrombose or malfunction during the entire period when a patient is dependent on dialysis. AV fistulas with direct arteriovenous anastomosis have a longer primary patency than PTFE graft (3 years vs. 1 year) while secondary patency, affected by multiple interventions, can last as long as 7 years in a CiminoBrescia shunt in the wrist, 3-5 years in the arm, and just 2 years for PTFE. Following irreversible recurrent failure of the initial AV fistula in spite of several revisions, new fistulas and grafts are inserted.
