To facilitate repeated intermittent hemodialysis, 57 patients at the University of Colorado Medical Center and the Denver Veterans Administration Hospital had arteriovenous shunts placed into their arms. The radial artery and cephalic vein were cannulated 3 cm proximal to the wrist on the nondominant arm. Fifty-four of the 57 patients had both vessels cannulated through a single incision, with an average length of 5 cm. The ligating suture on the vessel was tied around that portion of the siliconized rubber (Silastic) tube containing the vessel tip. Disengagement at this junction or postoperative bleeding requiring transfusion or surgical intervention never occurred. Twelve of the 17 patients who experienced complications (clotting, 12 instances; infection, 7; spasm, 3; disengagement, 2; and erosion, 2) required revision of their shunts. No complication was ever observed in the remaining 40 patients during their entire stay on the dialysis program.
Wolin LH. Arteriovenous Shunts for Prolonged Intermittent Hemodialysis: Technique, Survival, and Complications in 57 Patients. JAMA. 1967;202(2):99–103. doi:10.1001/jama.1967.03130150067010
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: