Table 1.

Summary of myths versus facts about vascular access

MythsFacts
AVFs have better survival than AVGsWhen you include AVFs that fail to mature, secondary survival is equivalent for AVFs and AVGs. Moreover, assisted AVF maturation is associated with shorter secondary survival and more frequent interventions after maturation
AVFs are cheaper than AVGsIf you analyze by intent to treat, AVFs are more expensive
Forearm AVFs are better than upper arm AVFsMost patients are getting upper arm AVFs because they have superior maturation rates
AVFs fail to mature primarily because of aggressive neointimal hyperplasia (inward remodeling)AVF maturation reflects a balance between inward and outward remodeling
CVCs are a major cause of deathCVC use is a surrogate marker of sicker patients. Very few deaths in patients with CVC are directly due to CVC complications
  • AVF, arteriovenous fistula; AVG, arteriovenous graft; CVC, central venous catheter.