The autogenous arteriovenous fistula (AVF) is the preferred access for chronic hemodialysis in patients with end-stage kidney disease. Careful examination of the upper extremity is essential for the creation of a successful fistula. The quality of the arterial and venous circulation should be well established prior to surgery. However, there are cases when the superficial venous system of the u...

Dialysis access surgery is currently one of the most common vascular operations as the dialysis patient population increases. Although autogenous arteriovenous fistulae stand as the preferred method of access due to excellent patency and lower complication rates, grafts may provide alternative approaches when an autogenous fistula is impractical usually due to depleted veins. We aimed in this s...

BACKGROUND The surgically created arteriovenous fistula has recently been recommended as the best available angioaccess for hemodialysis. Therefore, in this study, we carried out a clinical analysis on surgical procedures in the ligation and division of a distal vein to achieve similar effects as those of vein end-to-arterial side after side-to-side anastomosis. METHODS We retrospectively rev...

PURPOSE To choose the best arterial tourniquet for angioaccess surgery. METHODS Preventive hemostasis with an arterial tourniquet prevents bleeding and provides better visualization. The surgeon may currently use a traditional wide nonsterile inflatable pneumatic cuff after exsanguination with an Esmarch bandage or a disposable sterile narrow elastic silicone ring (HemaClear®), available in d...

BACKGROUND Obesity, which is often associated with diabetes, is increasingly encountered in the haemodialysed population, and this may produce difficulty in autogenous arteriovenous fistula creation. Prosthetic angioaccess or catheters, when used in place of autogenous fistulas, increase thrombotic and infectious complications in these already challenged patients. METHODS This prospective stu...

BACKGROUND The National Kidney Foundation has established detailed guidelines due to increasing morbidity and costs related to haemodialysis vascular access in the end-stage renal disease population. METHODS A quality assurance multidisciplinary committee was formed to implement the Dialysis Outcome Quality Initiative (DOQI) guidelines in September, 1999. Beginning January 2000, a 'Save the V...

OBJECTIVE The durability of cryopreserved allograft has been previously demonstrated in the setting of infection. The objective of this study was to examine the safety, efficacy, patency, and cost per day of graft patency associated with using cryopreserved allograft (vein and artery) for hemodialysis access in patients with no autogenous tissue for native fistula creation and with arteriovenou...

PURPOSE This study reports our midterm results with arteriovenous axillary loop grafts (AVALG) and evaluates their role in construction of vascular access for patients on chronic hemodialysis. METHODS The clinical data of 27 patients who underwent construction of an AVALG for hemodialysis access at our institution between July 2002 and December 2006 were analyzed retrospectively. Outcome meas...

Dr. Josep M. Campistol, Nephrology Service, Hospital Clinic i Provincial, 170, Villarroel, E-08036 Barcelona (Spain) Dear Sir, The upper graft fistula using the expanded polytetra-fluoroethylene graft (Goret-Tex) is an excellent form of hemodialysis access when adequate forearm veins are no longer available [1]. Causes of failure include thrombosis, arterial stenosis, venous outflow stenosis, h...