Background: Common problems with arteriovenous hemodialysis access were early graft thrombosis, prolong hemostasis time resulted from improper technique in compression. Reinforced PTFE graft offered stable, visualized contour which might decreased these problems.

Objective: This objective of this study was to evaluated the efficacy between the reinforced Polytetrafluoroethylene (PTFE) and the non-reinforced PTFE as the prosthetic graft in the forearm arteriovenous access in the aspects of 6-month primary patency, numbers of cannulation attempts, time to successful cannulation, hemostatic compression time and satisfaction level of dialysis nurses.

Material and Method: Sixty patients with end-stage renal disease suitable for forearm arteriovenous graft creation at Ramathibodi hospital were randomized to Non-reinforced and Reinforced PTFE graft access group. Demographic data were collected. Questionnaires were sent to dialysis nurses whom in-charge for access cannulation. The informations included date of cannulation, numbers of cannulation attempts on each hemodialysis session, experience of dialysis nurse, hemostatic compression time and satisfaction scores for the access in the first month of hemodialysis. Post-operative follow-up scheduled for the assessment of the patency, the forearm circumference at 2^nd week and 4^th week. The complications were recorded.

Results: The Reinforced PTFE group demonstrated comparable 6-month primary patency to non-reinforced PTFE group (100% vs. 100%), shorter time to successful cannulation (22 vs. 31.5, p<0.05), lower numbers of cannulation attempts (1 vs. 1.1, p<0.05), shorter compression time (5.64 vs. 7.61, p<0.05). Experience didn’t affect numbers of cannulation attempts on Reinforced PTFE group. There were no significant differences in the increased in Forearm circumference at postoperative period (2^nd week and 4^th week) compared with preoperative period between the two groups.

Conclusion: Reinforced PTFE graft had a comparable 6-month primary patency and complication rate with shorter duration of successful cannulation.

Keywords: Reinforce PTFE, Time to first cannulation, Patency rate, Hemodialysis