This study was performed to analyze factors affecting, patency and rate of complications of saphenous vein grafting for blood access in hemodialysis. Thirty-nine patients (40 procedures) who underwent implantation surgery between August 1989 and May 1997 in our hospital were studied. Patients were 26 to 84 years old (average 61 years old). The primary diseases were diabetic nephropathy in 17, chronic glomerulonephritis in 7, collagen disease in 4, and other in 11. Between August 1989 and May 1997, 21 patients survived, and 18 patients died.
The patency periods in surviving patients ranged from 0 to 62 months, with a mean of 22 months. The patency periods of non-surviving patients ranged from 0 to 49 months, with a mean of 11 months. The overall patency rate was 56% at 1 year, 52% at 2 years, and 21% at 5 years, the longest patency was 62 months. The patency rate in 26 cases (survival over 1 year) was 100% at 1 year, 85% at 2 years, and 32% at 5 years. Seventeen of 39 patients who received saphenous vein grafting had diabetic nephropathy. One case required PTA (percutaneous transluminal angioplasty) prior to occulusion, and the PTA was successful.
In conclusion, the auto-saphenous vein grafting is a useful means of achieving long-term patency with relatively easy maintenance.