Skip to main content
SpringerLink
Log in

Arteriovenous Hemodialysis Access

  • Chapter
  • First Online:
Essentials of Vascular Surgery for the General Surgeon

  • 2414 Accesses

Abstract

Hemodialysis access is the lifeline for patients with dialysis-dependent chronic kidney disease. The goal of this chapter is to provide the surgeon with a practical guide to arteriovenous (AV) access placement. The preoperative evaluation and planning of AV access for hemodialysis are described. In addition, a detailed description of vessel exposure and the common access procedures are provided. Some of the more frequently used alternative procedures are also described. Expectations of outcome are reviewed as well.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Levin AR. NKF-K/DOQI clinical practice guidelines for vascular access: update 2006. Am J Kidney Dis. 2006;48(suppl):S176–247.

    Google Scholar 

  2. Gibson KD, Gillen DL, Caps MT, Kohler TR, Sherrard DJ, Stehman-Breen CO. Vascular access survival and incidence of revisions: a comparison of prosthetic grafts, simple autogenous fistulas, and venous transposition fistulas from the United States Renal Data System Dialysis Morbidity and Mortality Study. J Vasc Surg. 2001;34(4):694–700.

    Article  PubMed  CAS  Google Scholar 

  3. De Marco Garcia LP, Davila-Santini LR, Feng Q, Calderin J, Krishnasastry KV, Panetta TF. Primary balloon angioplasty plus balloon angioplasty maturation to upgrade small-caliber veins (<3 mm) for arteriovenous fistulas. J Vasc Surg. 2010;52(1):139–44.

    Article  PubMed  Google Scholar 

  4. Wang BR, Rowe VL, Ham SW, Han S, Patel K, Weaver FA, Woo K. A prospective clinical evaluation of the effects of intraoperative systemic anticoagulation in patients undergoing arteriovenous fistula surgery. Am Surg. 2010;76(10):1112–4.

    PubMed  Google Scholar 

  5. Bhomi KK, Shrestha S, Bhattachan CL. Role of systemic anticoagulation in patients undergoing vascular access surgery. Nepal Med Coll J. 2008;10(4):222–4.

    PubMed  CAS  Google Scholar 

  6. Konner K, Nonnast-Daniel B, Ritz E. The arteriovenous fistula. J Am Soc Nephrol. 2003;14:1669–80.

    Article  PubMed  Google Scholar 

  7. Nguyen VD, Griffith CG, Treat L. A multidisciplinary team approach to increasing av fistula creation. Nephrol News Issues. 2003;17:54–7.

    PubMed  Google Scholar 

  8. Jennings WC. Creating arteriovenous fistulas in 132 consecutive patients. Arch Surg. 2006;141:27–32.

    Article  PubMed  Google Scholar 

  9. Rooijens PPGM, Tordoir JHM, Stijnen T, Burgmans JPJ, Smet de AAEA, Yo TI. Radiocephalic wrist arteriovenous fistula for hemodialysis: meta-analysis indicates a high primary failure rate. Eur J Vasc Endovasc Surg. 2004;28(15531191):583–9.

    Article  PubMed  CAS  Google Scholar 

  10. Palder SB, Kirkman RL, Whittemore AD, Hakim RM, Lazarus JM, Tilney NL. Vascular access for hemodialysis. Patency rates and results of revision. Ann Surg. 1985;202(2):235–9.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  11. Cantelmo NL, LoGerfo FW, Menzoian JO. Brachiobasilic and brachiocephalic fistulas as secondary angioaccess routes. Surg Gynecol Obstet. 1982;155:545–8.

    PubMed  CAS  Google Scholar 

  12. Gonzalez E, Kashuk JL, Moore EE, Linas S, Sauaia A. Two-stage brachial-basilic transposition fistula provides superior patency rates for dialysis access in a safety-net population. Surgery. 2010;148(4):687–93; discussion 693–4.

    Article  PubMed  Google Scholar 

  13. Hakaim AG, Nalbandian M, Scott T. Superior maturation and patency of primary brachiocephalic and transposed basilic vein arteriovenous fistulae in patients with diabetes. J Vasc Surg. 1998;27(1):154–7.

    Article  PubMed  CAS  Google Scholar 

  14. Kumano S, Itatani K, Shiota J, Gojo S, Izumi N, Kasahara H, Homma Y, Tagawa H. Strategies for the creation and maintenance of reconstructed arteriovenous fistulas using the forearm basilic vein. Ther Apher Dial. 2013;17:504–9.

    PubMed  Google Scholar 

  15. Weyde W, Letachowicz W, Krajewska MK, Letachowicz K, Watorek E, Kusztal M, Porazko T, Gołebiowski T, Madziarska K, Klinger M. Native forearm fistulas utilizing the basilic vein: an underused type of vascular access. J Nephrol. 2008;21:363–7.

    PubMed  Google Scholar 

  16. Ayez N, van Houten VA, de Smet AA, van Well AM, Akkersdijk GP, van de Ven PJ, Fioole B. The basilic vein and the cephalic vein perform equally in upper arm arteriovenous fistulae. Eur J Vasc Endovasc Surg. 2012;44:227–31.

    Article  PubMed  CAS  Google Scholar 

  17. Bronder CM, Cull DL, Kuper SG, et al. Fistula elevation procedure: experience with 295 consecutive cases during a 7-year period. J Am Coll Surg. 2008;206(5):1076–81; discussion 1081–2.

    Article  PubMed  Google Scholar 

  18. Causey MW, Quan R, Hamawy A, Singh N. Superficialization of arteriovenous fistulae employing minimally invasive liposuction. J Vasc Surg. 2010;52(5):1397–400.

    Article  PubMed  Google Scholar 

  19. Francis DM, Lu Y, Robertson AJ, Millar RJ, Amy J. Two-stage brachiobasilic arteriovenous fistula for chronic haemodialysis access. ANZ J Surg. 2007;77(3):150–5.

    Article  PubMed  Google Scholar 

  20. Zielinski CMV, Mittal SK, Anderson P, Cummings J, Fenton S, Reiland-Smith J, Frock JT, Dunlay RW. Delayed superficialization of brachiobasilic fistula: technique and initial experience. Arch Surg. 2001;136:929–32.

    Article  PubMed  CAS  Google Scholar 

  21. Hossny A. Brachiobasilic arteriovenous fistula: different surgical techniques and their effects on fistula patency and dialysis-related complications. J Vasc Surg. 2003;37(12663983):821–6.

    Article  PubMed  Google Scholar 

  22. Vascular Access Work Group. Clinical practice guidelines for vascular access. Am J Kidney Dis. 2006;48 suppl 1:S248–73.

    Google Scholar 

  23. Segal JH, Kayler LK, Henke P, Merion RM, Leavey S, Campbell DA. Vascular access outcomes using the transposed basilic vein arteriovenous fistula. Am J Kidney Dis. 2003;42(1):151–7.

    Article  PubMed  Google Scholar 

  24. Humphries Jr AL, Colborn GL, Wynn JJ. Elevated basilic vein arteriovenous fistula. Am J Surg. 1999;177:489–91.

    Article  PubMed  Google Scholar 

  25. Sparks SR, VanderLinden JL, Gnanadev DA, Smith JW, Bunt TJ. Superior patency of perforating antecubital vein arteriovenous fistulae for hemodialysis. Ann Vasc Surg. 1997;11(2):165–7.

    Article  PubMed  CAS  Google Scholar 

  26. Mousa AY, Patterson W, Abu-Halimah S, Hass SM, Alhalbouni S, Sadek BT, Nanjundappa A, Modak A, Stone PA, Emmett M, AbuRahma AF. Patency in arteriovenous grafts in hemodialysis patients. Vasc Endovascular Surg. 2013;47:438–43.

    Article  PubMed  Google Scholar 

  27. Tashjian DB, Lipkowitz GS, Madden RL, Kaufman JL, Rhee SW, Berman J, Norris M, McCall J. Safety and efficacy of femoral-based hemodialysis access grafts. J Vasc Surg. 2002;35:691–3.

    Article  PubMed  Google Scholar 

  28. Geenan IL, Nyilas L, Stephen MS, Makeham V, White GH, Verran DJ. Prosthetic lower extremity hemodialysis access grafts have satisfactory patency despite a high incidence of infection. J Vasc Surg. 2010;52:1546–50.

    Article  Google Scholar 

  29. Jean-Baptiste E, Hassen-Khodja R, Haudebourg P, Declemy S, Batt M, Bouillanne PJ. Axillary loop grafts for hemodialysis access: midterm results from a single-center study. J Vasc Surg. 2008;47:138–43.

    Article  PubMed  Google Scholar 

  30. Morsy MA, Khan A, Chemla ES. Prosthetic axillary-axillary arteriovenous straight access (necklace graft) for difficult hemodialysis patients: a prospective single-center experience. J Vasc Surg. 2008;48(5):1251–4, 1254 e1251.

    Article  PubMed  Google Scholar 

  31. Scott JD, Cull DL, Kalbaugh CA, Carsten CG, Blackhurst D, Taylor SM, Snyder BA, York JW, Langan EM. The mid-thigh loop arteriovenous graft: patient selection, technique, and results. Am Surg. 2006;72(9):825–8.

    PubMed  Google Scholar 

  32. Gradman WS, Laub J, Cohen W. Femoral vein transposition for arteriovenous hemodialysis access: improved patient selection and intraoperative measures reduce postoperative ischemia. J Vasc Surg. 2005;41(2):279–84.

    Article  PubMed  Google Scholar 

  33. Hazinedaroglu SM, Tuzuner A, Ayli D, Demirer S, Duman N, Yerdel MA. Femoral vein transposition versus femoral loop grafts for hemodialysis: a prospective evaluation. Transplant Proc. 2004;36:65–7.

    Article  PubMed  CAS  Google Scholar 

  34. Pierre-Paul D, Williams S, Lee T, Gahtan V. Saphenous vein loop to femoral artery arteriovenous fistula: a practical alternative. Ann Vasc Surg. 2004;18(2):223–7.

    Article  PubMed  Google Scholar 

  35. Katzman HE, McLafferty RB, Ross JR, Glickman MH, Peden EK, Lawson JH. Initial experience and outcome of a new hemodialysis access device for catheter-dependent patients. J Vasc Surg. 2009;50(3):600–7, 607 e601.

    Article  PubMed  Google Scholar 

  36. Nassar GM, Glickman MH, McLafferty RB, Kevin CJ, Zarge JI, Katzman HE, Peden EK, Lawson JH, Martinez JM, Thackeray L. A comparison between the HeRO Graft and conventional arteriovenous grafts in hemodialysis patients. Semin Dial. 2014. doi:10.1111/sdi.12173. [Epub ahead of print].

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Vascular Surgery and Endovascular Services, Department of Surgery, SUNY Upstate Medical University, Syracuse, NY, USA

    Anjuli R. Cherukuri MD

  2. Division of Vascular Surgery and Endovascular Services, SUNY Upstate Medical University, 750 East Adams Street, Suite 8801, Syracuse, NY, 13210, USA

    Vivian Gahtan MD, FACS

  3. Department of Veterans Affairs Healthcare Network Upstate New York at Syracuse, Syracuse, NY, USA

    Vivian Gahtan MD, FACS

Authors
  1. Anjuli R. Cherukuri MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vivian Gahtan MD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vivian Gahtan MD, FACS .

Editor information

Editors and Affiliations

  1. Chief, Division of Vascular Surgery and Endovascular Services, and Lead Physician, Vascular Surgery Department of Veterans Affairs Healthcare, SUNY Upstate Medical University, and Network Upstate New York at Syracuse, Syracuse, New York, USA

    Vivian Gahtan

  2. Director of Endovascular Services, Division of Vascular Surgery and Endovascular Services, and Vascular Surgeon, Department of Veterans Affairs Healthcare, SUNY Upstate Medical University, and Network Upstate New York at Syracuse, Syracuse, New York, USA

    Michael J. Costanza

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this chapter

Cite this chapter

Cherukuri, A.R., Gahtan, V. (2015). Arteriovenous Hemodialysis Access. In: Gahtan, V., Costanza, M. (eds) Essentials of Vascular Surgery for the General Surgeon. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1326-8_18

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-1326-8_18

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1325-1

  • Online ISBN: 978-1-4939-1326-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation