Arteriovenous fistulae for chronic intermittent haemodialysis: A modified surgical technique

Abstract

Abstract A side-to-end technique for arteriovenous fistulae of the wrist vessels for use in chronic intermittent haemodialysis with venepuncture is proposed. A series of 14 patients in whom this technique has been used is presented. A survey of the different shunting techniques described in the literature is given and their advantages and disadvantages are discussed. The problem of turbulence due to a sharp angulation of the flow through the anastomosis and the possibility of its causing aneurysmata and thrombosis of the fistulae are considered. This problem and its sequelae, together with the problem of the use of the sole remaining artery of the hand when the other has been either occluded or ligated in previous operations, and the possibility of creating an arteriovenous fistula with a vein distant from the artery, are all overcome by this technique.