Solution Seeking for Arteriovenous Fistula Formation in End-Stage Renal Failure Patients: A New Trial: Surgical Technique

Some problems have been encountered during creation of arteriovenous fistulae in hemodialysis- dependent end stage renal failure patients. Patient-related factors such as insufficient blood flow due to atherosclerosis of the arterial bed, insufficiency of venous vessel diameters and phlebitic or thrombotic veins play an important role in these problems. The quality of the surgical anastomosis is a must. In chronic renal failure patients, when the radial artery is atherosclerotic, it becomes more difficult to create an arteriovenous fistula in the forearm. First, the radial artery blood flow must be resolved. To resolve the blood flow of the radial artery, we performed brachioradial bypass with an autogenous saphenous vein graft in 4 patients, and then created a simultaneous graft-saphenous arteriovenous fistula. In the postoperative follow-up, the fistulae were seen to be patent, and thrill was positive. Patients continued to undergo hemodialysis. We suggest that this technique can be performed in patients with advanced radial artery atherosclerosis.