The use of native arteriovenous fistulas (AVF) for hemodialysis (HD) is the gold standard, however, for many patients, this is not an option. We hypothesize that bovine carotid artery (BCA) is an efficient alternative non-autologous arteriovenous HD access.

We reviewed the records of patients (n=677) who underwent surgical placement of an HD access including AVF, BCA, and polytetrafluoroethylene (PTFE) from October 2011 – March 2015.

Results included placement of 428 AVF, 187 BCA, and 62 PTFE grafts. There were no differences between groups for the mean age, length of stay, revision, stenosis, infection, steal syndrome or percent of patients who received kidney transplants. One year primary patency occurred in 28.7 % of AVF, 25.1% of BCA and 8.1% of PTFE (p-value 0.014). There was no significant difference in assisted primary patency rates. The 1 yr. secondary patency rate was greatest for PTFE (22.6%), followed by BCA (19.8%) and least for AVF (11%) (p-value 0.008). The overall 1-year patency rate was highest for BCA at 64% compared to 62% and 45% for AVF and PTFE respectively. The rate of thrombosis was greatest for PTFE (27.4%), followed by BCA (19.8%), and AVF (10.5%) (p-value 0.0001). Failure to mature presented in 5.4% of AVF but in none of the BCA or PTFE grafts (p-value 0.001). Accesses were abandoned with PTFE (6.5%) > AVF (1.4%) > BCA (1.0%) with a p-value of 0.041.

Based on our findings, we concluded that BCA is an effective alternative form of HD access based on patency and complication rates. These results are limited to a short term, single-center, retrospective study. A prospective randomized investigation is warranted.

CITATION INFORMATION: Bowers V, Pearson H, Huang J, Leone J, Tanious A, Dawley K, Rogers E, Camba V, Albertson C, Lahiff D, Rashid T, Buggs J. Retrospective Analysis of Multiple Hemodialysis Access Modalities. Am J Transplant. 2017;17 (suppl 3).

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