July 1976

Enhancement of Flow Through Arteriovenous Fistula

Author Affiliations

Beverly Hills, Calif

Arch Surg. 1976;111(7):831. doi:10.1001/archsurg.1976.01360250107026

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To the Editor.—It is an affront to the technical knowledge and common sense of vascular surgeons to publish an article on technique (Arch Surg 111:195, 1976) with a photograph (Fig 3) that shows a bulldog clamp crushing the vein that is being prepared for angioaccess.

The maneuver of hydrostatic dilation of a vein can be accomplished by using gentle digital compression to occlude the vein, as the article indicates. Silastic tubing loops can be employed for the same purpose. The use of bulldog clamps for occluding blood vessels as delicate as cephalic veins should be condemned. Publishing such practice will lead the novice to a high incidence of inflow stenoses.

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