Author`s Reply

To the Editor,

We are grateful to the authors for their interest and kind contribution to our study, published in The Anatolian Journal of Cardiology 2014; 14: 542-6. (1) entitled “Longterm patency of autogenous saphenous veins vs. PTFE interposition graft for prosthetic hemodialysis access.”. When simple arteriovenous fistulas fail, the need for new, practical, and effective vascular access gains extra importance. The major aim of the further intervention should be to provide safe and comfortable access as soon as possible.

As mentioned by the authors, international initiatives and foundations recommend the basilic vein transposition (BVT) technique as a third-line vascular access point after performing simple radio-cephalic or brachio-cephalic anastomosis. These recommendations were clearly cited in our text. The reason for performing bridge graft interpositioning in our cohort was the predominance of obese and female patients, which were accepted as technical drawbacks by many surgeons. BVT surgery may be strongly predicted to fail or reveal an ineffective vascular access site in these types of patients due to the limited basilic vein length and excessive adipose tissue.

Saphenous veins are precious autologous grafts, and synthetic grafts were the predominantly used graft types in previous studies (comparing BVT with graft interpositioning). Even though this is our personal opinion, saphenous vein grafts may contribute to the final outcome if they are used as a first-line graft choice.