Effective arteriovenous fistula alternative for hemodialysis access

Abstract Background The use of autologous arteriovenous fistulae (AVF) for hemodialysis (HD) is the gold standard; however, for many patients at tertiary referral centers, this is not an option. Methods We conducted a four year retrospective cohort study to evaluate HD access outcomes with AVF, bovine carotid artery (BCA), and polytetrafluoroethylene arteriovenous graft (PTFE). Results The study contained 416 AVF, 175 BCA, and 58 PTFE, N = 649. There was statistical difference between rates of infection (AVF 3.4%, BCA 2.9%, PTFE 11.9%), P  = 0.02. Maturation failed in 7.5% of AVF but in none of the BCA or PTFE ( P =  0.001). Accesses were abandoned with AVF (1.9%), BCA (1.5%), and PTFE (9.5%), P =  0.01. Conclusion Bovine carotid artery can be an effective alternative form of HD access with lower infection, abandonment, and failure to maturation rates when autologous arteriovenous fistula is not an option.