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Abstract
Since July, 1972, we have converted 14 Scribner shunts, which we had used for the
initiation of hemodialysis in 14 patients with end-stage renal disease, to arteriovenous
fistulas in the same peripheral artery and vein of the shunts for maintenance chronic
dialysis. The shunts were converted to fistulas electively in three patients and because
of malfunction in 11. We did not convert infected shunts. Dialysis was resumed within
24 to 72 hours of conversion to a fistula in all 14 patients. Thirteen patients were
followed from 14 to 1,505 days with pump speeds of about 300 cc/minute. The fistulas
continued to function without complication. One patient developed a small pseudoaneurysm,
which required excision. The overall patency rate was 93%. The autogenous peripheral
vessels of a patient on chronic hemodialysis are a limited resource. This conversion
or recycling technique will give the patient a preferred vascular access for dialysis
for prolonged periods.
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References
- Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula.N Engl J Med. 1966; 275: 1089
- Advantages of arteriovenous fistulas for hemodialysis.Arch Surg. 1971; 102: 359
- Swelling of the hand after arteriovenous fistula for hemodialysis.Am J Surg. 1976; 132: 373
- Cannulation of blood vessels for prolonged hemodialysis.Trans Am Soc Artif Intern Organs. 1960; 6: 104
Article info
Footnotes
☆Presented at the Thirty-fourth Annual Meeting of the Central Surgical Association, Buffalo, N. Y., March 3–5, 1977.
Identification
Copyright
© 1977 Published by Elsevier Inc.
