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  XIV CONGRESS OF THE SOCIETA' ITALIANA DI NEFROLOGIA SEZIONE PIEMONTE-VALLE D'AOSTA
(Ivrea, October 5, 1996)
 

Minerva Urologica e Nefrologica 1998 March;50(1)39-43

Copyright © 1998 EDIZIONI MINERVA MEDICA

language: Italian

High flux arteriovenous fistula at the anatomic snuff-box

Boccardo G., Ettari G., Donato G., De Prisco O., Maurino D.

USL 16 - Regione Piemonte - Ceva (Cuneo), UOA di Nefrologia e Dialisi


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Based on 25 years of haemodialysis experience, the authors confirm the importance of arteriovenous fistula at the anatomic snuff-box by L-L anastomosis with vessel end-tie, and assert that, even using small vessels, through simple devices, it is possible to achieve high-flux vascular access, that can be employed also for high-efficiency treatments (HF, HDF). The advantages and the troubles of this vascular access are considered and also the reasons that lead to dropping this arteriovenous fistula too. The authors describe the surgical technique and the devices of the procedure, based on their case-reports of 131 arteriovenous fistulas at the anatomic snuff-box, immediately working in 95% of the cases and compatible with high-flux blood in 67% of cases. Fine adventitial bridle resection is very important, because this procedure allows us to rest the venous vessel wall on the top of the fistula; the ligature of all collateral vessels is very important too. The arteriovenous fistula at the anatomic snuff-box (L-L terminated, with anastomotic leak of 5 mm) is the most advisable vascular access for all the patients in whom we can plan the start of dialysis some months advance.

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