Hemodialysis Access Part B — Permanent
The introduction of extracorporeal dialysis of blood by Kolff et al. (1) in 1943 provided a means whereby patients with end stage renal failure could be sustained for prolonged periods by intermittent filtering of uremic toxins from the blood. Temporary access to the circulation by catheterization of distal arteries and veins using glass or metal cannulae was performed originally, with the used portions of the vessels ligated following each dialysis treatment. Chronic dialysis was not feasible until the introduction of the external arteriovenous shunt by Quinton, Dillard and Scribner in 1960 (2) and the endogenous fistula by Brescia, Cimino and colleagues in 1966 (3), approaches that afforded routine intermittent access to the circulation without sacrifice of the vessels after each treatment. The increased availability of synthetic vascular prostheses, especially expanded polytetrafluoroethylene (PTFE), has allowed a greater procedural choice, particularly in chronic dialysis patients whose peripheral venous sites have been exhausted or whose native veins are inadequate for the creation of an endogenous fistula.
KeywordsBrachial Artery Arteriovenous Fistula Cephalic Vein Prosthetic Graft PTFE Graft
Unable to display preview. Download preview PDF.
- 5.Whittemore AD: Vascular access for hemodialysis. in Surgical Care of the Patient with Renal Failure, edited by Tilney NL, Lazarus JM, Philadelphia, WB Saunders Co, 1982, p 49Google Scholar
- 6.Tilney NL, Whittemore AD: Dialysis access in difficult patients. in Vascular Surgery, edited by Bell PRF, Tilney NL, London, Butterworths, 1984, p 175Google Scholar
- 7.Bossell JA, Abbott JA, Lim RC: A radial steal syndrome with arteriovenous fistula for hemodialysis. Ann Intern Med 75:387, 1971Google Scholar
- 11.Gerardet RE, Hackett RE, Goodwin NJ, Friedman EA: Thirteen months’ experience with the saphenous vein graft arteriovenous fistula for maintenance hemodialysis. Trans Am Soc Artif Intern Organs 16: 285, 1970Google Scholar
- 12.Morgan AP, Dammin GJ, Lazarus JM: Failure modes in secondary vascular access for hemodialysis. ASAIO J 1: 44, 1978Google Scholar
- 13.Hammill FS, Johnson GG, Collins GM: A critical appraisal of the changing approaches to vascular access for chronic dialysis. Proc Eur Dial Transplant Assoc 9: 325, 1980Google Scholar
- 25.Surratt RS, Picus D, Hicks ME, Darcy MD, Kleinhoffer M, Jendrisak M: The importance of preoperative evaluation of the subclavian vein in dialysis access planning. Am J Roentgenol 156: 623, 1991Google Scholar
- 29.Sabanayagam P, Soricelli R, Schwartz A: Experience with 225 expanded PTFE arteriovenous fistulae for chronic maintenance hemodialysis. Presented at the Annual Meeting of the European Society for Artificial Organs, Geneva, Switzerland, Sept 29–Oct 1, 1979Google Scholar
- 36.Bhat DJ, Tellis VA, Kohlberg WI, Driscoll B, Veith FJ: Management of sepsis involving expanded polytetrafluoroethylene grafts for hemodialysis access. Surgery 187: 445, 1980Google Scholar
- 39.Gifford RM: Management of tunnel infections of dialysis polytetrafluoroethylene grafts. J Vasc Surg 2: 85ft, 1985Google Scholar
- 40.Dobkin JF, Miller MH, Steigbigel NA: Septicemia in patients on chronic hemodialysis. Ann Intern Mid 88: 28, 1978Google Scholar
- 41.O’Brien TF: Infection in dialysis and transplant patients. in Surgical Care of the Patient with Renal Failure, edited by Tilney NL, Lazarus JM, Philadelphia, WB Saunders Co, 1982, p 67Google Scholar