Long-term patency of autogenous saphenous veins vs. PTFE interposition graft for prosthetic hemodialysis access

We appreciate the fluency of the original article by Uzun et al. (1) entitled “Long-term patency of autogenous saphenous veins vs. PTFE interposition graft for prosthetic hemodialysis access,” which was recently published in Anatol J Cardiol 2014; 14: 542-6.” The authors divided the study population in two groups, those who used autogenous saphenous grafts and those who used PTFE. Although the investigators used saphenous grafts in both the upper arm and forearm, they used PTFE only in the upper arm. It is known that using the same autogenous grafts in different parts of the extremities could cause distinct long term patency. There are considerable peculiarities among the use of autogenously grafts in different regions in terms of infection, steal syndrome, and heart failure (2). In addition, some studies have reported that different autogenous grafts could cause different results even when used in same region (3). In the aforementioned study, although the investigators used autogenous saphenous grafts mostly in the distal part of the upper extremity, they used PTFE mostly in the proximal part of the upper extremity. To our knowledge, this factor could affect the grafts in terms of patency and infection risk. Generally, same regions were used among the studies in the literature; these studies compared different kinds of grafts (4). We want to understand the opinion of the authors regarding this.