Subcutaneous arteriovenous fistulas for hemodialysis

Arteriovenous fistulas in the arms to permit hemodialysis have been created eighty-four times in patients with chronic renal failure. Direct anastomosis between the radial artery and cephalic vein was performed thirty-two times. An interposed graft for hemodialysis was created from a segment of saphenous vein fifty-two times. Chronic patency was maintained in 90 and 95 per cent, respectively. Of the two methods, the vein graft fistulas were superior because of their immediate availability and the ease of needle insertion. In our experience subcutaneous arteriovenous fistulas have proved to be very satisfactory and superior to external shunts in the management of patients requiring chronic hemodialysis.