The complications of arteriovenous grafts for vascular access.

An analysis has been made of the complications occurring in 86 arteriovenous grafts performed for vascular access over a 5-year period ending in July 1979. Synthetic grafts provide significantly more complication-free dialyses than do biological grafts. They are less susceptible to sepsis and aneurysm formation and, when thrombosis does supervene, synthetic grafts can be retrieved than biological grafts. Dacron velour in particular appears to have a low primary and secondary failure rate compared with other types of graft. Grafts implanted in the straight configuration have lower thrombosis rates than looped grafts. While the forearm remains the site of choice for the insertion of an arteriovenous graft, equally good results may be obtained with a graft interposed between the femoral artery and vein.