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The radial artery-cephalic vein arteriovenous fistula is commonly used to provide circulatory access in patients on chronic hemodialysis. The technique described here emphasizes the value of using two longitudinal incisions (Fig 1, 1) instead of one transverse incision.
Under local anesthesia, an incision is first made along the course of the cephalic vein at the wrist. The tributaries of the vein are ligated with No. 4-0 silk and divided. This allows complete mobilization of the distal 4 to 5 cm of the cephalic vein. The end of the vein is cannulated with a horsely needle and distended with heparinized Ringer's lactate solution, while the proximal vein is compressed (Fig 1,2). If the vein distends well and there is minimal resistance to infusion of fluid, the procedure is continued. The radial artery is exposed through a separate incision and the end of the vein is brought through
LOGERFO FW, DAVIS RC. Radial-Cephalic Arteriovenous Fistula Technique. Arch Surg. 1979;114(3):346. doi:10.1001/archsurg.1979.01370270116029